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Trump and RFK Jr. are making claims about autism. What do medical experts say?

23 September 2025 at 19:00

Ashley Mathy and Cindy Bentley, who both identify as having autism, record a video for the Self Determination channel on YouTube, a project of the Wisconsin Board for People with Developmental Disabilities (BPDD). States Newsroom spoke with three medical experts about the state of research as well as the complexity involved in understanding autism spectrum disorder. (Photo courtesy of the Wisconsin BPDD)

WASHINGTON — Health and Human Services Secretary Robert F. Kennedy Jr. stirred up major concerns and considerable speculation earlier this year when he announced the administration would release a report revealing the causes of autism by the end of September. 

Kennedy, an environmental lawyer with no medical degree, stood next to President Donald Trump on Sept. 22 as they presented the over-the-counter drug Tylenol as one potential driving factor behind autism diagnoses and pointed to folate, a B vitamin, as a possible treatment — both conclusions the medical community hasn’t yet reached. 

Kennedy throughout his tenure has also made overly broad and disparaging statements about people who have an autism diagnosis, often referring to traits exhibited in people with the most severe cases. For example, he claimed in April that children with autism would never function as independent adults, drawing intense criticism for making a generalization that would not apply to every person with a diagnosis.

The Trump-Kennedy announcement and Kennedy’s characterizations have raised questions about why someone would be diagnosed, what types of research have been done and what reputable science has found about causes. 

States Newsroom spoke with three experts before the announcement to gain a better understanding of autism spectrum disorder. Below are brief excerpts from those interviews. 

What is autism spectrum disorder? 

The two core characteristics of autism are challenges with social communication and the presence of restrictive and repetitive behavior, according to Autism Science Foundation Chief Science Officer Dr. Alycia Halladay. 

As understanding of the diagnosis has evolved, she explained, researchers and families have increasingly referred to it as autisms, plural, instead of autism, singular, in part, because there are so many different subtypes.

“It makes it more accurate when describing it — that autism is not just one entity of core autism features, that there is so much diversity across the spectrum, that it’s actually a group of developmental disorders,” Halladay said. 

The spectrum, she said, ranges from people who may speak rarely to those who are fluent in language, people with cognitive disabilities to those with IQs of more than 120 and people who can live independently to those who need round-the-clock care.

Dr. Michael Murray, a professor in the Department of Psychiatry and Behavioral Health at the Penn State College of Medicine, described it as “a neurodevelopmental disorder, meaning that people are born with it and it’s lifelong and it can cause a variety of challenges for people.”

“The most common and significant and probably pervasive symptom across the spectrum is challenges in understanding and interpreting what we call neurotypical — meaning everyone who is non-autistic — social behavior,” Murray said. “So just understanding all the non-verbal parts of social communication, understanding nuance and non-literal use of language. All those things can be really difficult for autistic people.”

Approximately 1 in 31 children in the United States and 1 in 45 adults fall somewhere along the autism spectrum,  according to data from the Centers for Disease Control and Prevention and a paper published in the Journal of Autism and Developmental Disorders. 

How is autism diagnosed?

Only an expert can diagnose an autism spectrum disorder using criteria in a guide used by health care professionals called the Diagnostic and Statistical Manual of Mental Disorders, or DSM. 

“You need someone who knows autism, who knows what to look for, who knows how to elicit behaviors or not elicit behaviors that are indicative of an autism diagnosis,” Halladay said. “So it’s really diagnosed by a psychiatrist, a psychologist, or somebody else who’s trained to understand what autism is and what it’s not.”

Murray said there are three social communication behaviors that doctors or other qualified medical professionals look for when considering whether to diagnose someone with autism. 

“It is difficulty in interpreting social information. It is difficulty giving social information through things like facial expression and tone of voice. And thirdly, is a difficulty maintaining appropriate peer relationships,” Murray said. “Now, once again, this is from a neurotypical description of peer relationships. There’s a lot of talk among neurodivergent individuals about whether that’s fair, that we rate social relationships based on how we think they should be. But nonetheless, that’s the criteria.”

Murray explained experts also observe the presence of restrictive and repetitive behaviors in assessing whether someone has autism. 

“And that captures things that are in the realm of interacting with the physical world around you,” Murray said. “So that need for sameness and inflexibility maintaining routines.”

Carissa Cascio, a senior scientist at the University of Kansas Life Span Institute and Kansas Center for Autism Research and Training, reinforced that autism is “strictly diagnosed based on behavior.”

“There are genes that have an association with autism that you can test for. There’s some genes that have a very strong association, and you can do a test for the presence of one of those genes,” Cascio said. “But for the diagnosis of autism itself, it’s strictly based on behavior.”

What do we know about the causes of autism?

While more scientific research is needed, a combination of genetics and environmental factors is responsible for the formation of autism spectrum disorders. 

“We know that one of the largest causes of autism is genetics. We know this because it runs in families,” Halladay said, adding there “are over 150 known genes associated with autism.”

“If there’s a variation in the gene, there’s a high likelihood of having an autism diagnosis,” she said. “And those genes are genes that tell cells in the brain where to go and how to connect, which seems to be a core biological feature of autism.”

Halladay emphasized that research has established the “most important part is the interaction between genetics and the environment.”

“Neither the gene nor the environmental factor is strong enough, but together, they increase the probability of having a child with autism,” Halladay explained. 

During the last 25 years, as Murray has advanced in his career, the medical community’s thinking about and understanding of autism spectrum disorders has “significantly increased.”

“We know right now that 80 to 90% of autism is accounted for by genetic differences …. It’s not just you got exposed to this thing in the environment, now you have autism. You have to have the genetic susceptibility first and then the environment might make it more likely, or maybe influence the expression of it,” Murray said.

Cascio said that when it comes to environmental factors, studies have shown pregnancy or the very early post-natal time frame are key. 

“We’re still parsing this out, but some of the environmental factors that seem to have more evidence behind them than others are older parental age, perinatal trauma, premature birth and low birth weight,” Cascio said. “And then there’s some maternal health factors that are gathering some evidence as well. So maternal infection and immune response, maternal exposure to medications or pollutants are sort of gathering some evidence.” 

While much more research is needed on the many potential environmental factors, Cascio said scientists know vaccines are not a component. 

“The things that we definitely can rule out are things that have been studied in great depth and not really produced much association. So you know, the idea that vaccines cause autism is a common belief. There have been dozens and dozens of studies that have all failed to find any association between vaccines and autism,” Cascio said.

There’s also not yet a clear link with Tylenol, also called acetaminophen, as a possible environmental factor. 

“It is unlikely that this is the smoking gun that they’re hoping for,” Cascio said. “I think we all want to understand this better, but this is certainly not something that we feel has a strong weight of evidence behind it yet.”

A spokesperson for Kenvue, the company that manufactures Tylenol, wrote in a statement released in connection with the Trump-Kennedy press conference that “acetaminophen is the safest pain reliever option for pregnant women as needed throughout their entire pregnancy.  

“Without it, women face dangerous choices: suffer through conditions like fever that are potentially harmful to both mom and baby or use riskier alternatives. High fevers and pain are widely recognized as potential risks to a pregnancy if left untreated.”

Why have autism diagnoses increased over several decades? 

Health and Human Services Secretary Kennedy has repeatedly raised concerns with an increase in autism diagnoses over several decades, but experts say there are logical reasons for this. 

“In the early 1990s the CDC set up a system to collect and count the number of people with autism,” Halladay said. “So it definitely has increased since then, but one of the main reasons that’s been shown over and over again is access to services.”

Halladay believes most of the increase is due to greater knowledge and access, though she said, “there is room for some of the increase in autism to be a true increase in the number of people with autism due to something else.”

Murray explained that about 60% to 70% of people diagnosed as being on the autism spectrum are characterized as having “low-support needs, meaning that they clearly have the features of autism, but they are able to, with the appropriate level of supports, be in traditional schools or typical schools; they can, with job support, work and lead their lives the way they choose to.”

When Murray began his career, he said, those people never would have been diagnosed as having autism.  

“Secondly, we as a professional community are getting better and better at picking up these symptoms, particularly in kids who are quite young,” Murray said.

During the late 1980s and 1990s, Cascio said, a new version of the DSM and better tools helped medical professionals more accurately diagnose people along the entire autism spectrum. 

Additionally, Cascio said, there’s a similar concept called diagnostic substitution, where people who in the past may have been diagnosed with something else are now being correctly diagnosed with autism. 

How much research has been done on autism and over how many years?

Scientists have been researching autism for decades, building on past work to better understand how to diagnose and assist people across the spectrum, though experts said more is needed.

“The many, many scientific discoveries and funding into understanding autism has promoted scientists moving into the field,” Halladay said. “So there’s clearly an increased number over the past two decades of the number of people who are focused on studying autism.”

Murray said the first papers published in scientific journals regarding autism were in 1944. 

“So it is 80 years, at a minimum, of work,” Murray said.

Murray reiterated that autism spectrum disorders are not simple to study and said a “really important paper came out earlier this year talking about how there’s four genetically recognizable subtypes of autism. So it’s not a single autism. It is, at the very least, four autisms, and probably more.”

Cascio said addressing any aspect of autism is complicated.

“The behavior is complex. The genetics are complex. The brain is complex,” Cascio said. “And so this makes it a huge challenge for research. And there’s certainly no possibility that we would go from not fully understanding the causes of autism to having a definitive cause in five months.”

What are some of the biggest misconceptions about autism? 

The internet has led to misinformation, and in many cases disinformation, and health diagnoses are no exception.  

Halladay said people often try to simplify autism or believe an actor’s portrayal in a television show or movie is representative of everyone on the spectrum. 

“I think that because of the narrative of autism being oversimplified, that people are not understanding that it’s a more complex disorder,” she said. 

Murray said the autism spectrum may be pictured as a straight line and an expectation arises when someone is diagnosed that they are in just one spot. 

“That’s not really the way it is. There are needs or strengths that show up variably depending on the demands of the situation,” Murray said. “So for instance, someone who has a really exquisite sensitivity to sound, if they are attending a symphony, that may make that experience so much more rich for him or her versus the average person. 

“But if they are at a rock concert, it may be overwhelming. The same trait can be a source of vulnerability or a strength depending on the situation.”

Murray said there’s often a misconception that all people with autism are antisocial or don’t want to make and maintain friendships.  

“And that’s true for some people, right? They aren’t really interested in social interactions. It’s not their thing,” Murray said. “It’s also true for some neurotypical people that they’re really not interested in social interactions. But the vast, vast majority of autistic individuals just want a friend, and they want someone who they can count on and rely on. They want to be loved, just like everyone else in the world … They just need more supports or different situations to have that happen.”

Cascio said that people can form misconceptions after seeing actors portray people along the spectrum.

“I first became interested in autism after watching the movie ‘Rain Man,’” Cascio said. “And I think there’s a lot of people who see a depiction like that and think, ‘Okay, this is what autism looks like.’ And there’s just so much more complexity and variability from person to person and I would say that’s probably the biggest misconception.”

Cascio said it’s also human nature to want one clear answer to why someone develops autism or any other health diagnosis, but that oftentimes the best science shows a more complicated picture. 

“It’s uncomfortable for us to say, ‘This is really complex and we don’t understand it yet,’” she said. “And so when there is something that people hold up and say, ‘Here’s an explanation.’ I think it can be really tempting for people to just want to have it solved. And that’s a very natural reaction.”

Trump ties autism to Tylenol use in pregnancy despite inconclusive scientific evidence

22 September 2025 at 23:43
U.S. Health and Human Services Secretary Robert F. Kennedy Jr., joined by President Donald Trump, delivers an announcement on “significant medical and scientific findings for America’s children” in the Roosevelt Room of the White House on Sept. 22, 2025 in Washington, D.C.  (Photo by Andrew Harnik/Getty Images)

U.S. Health and Human Services Secretary Robert F. Kennedy Jr., joined by President Donald Trump, delivers an announcement on “significant medical and scientific findings for America’s children” in the Roosevelt Room of the White House on Sept. 22, 2025 in Washington, D.C.  (Photo by Andrew Harnik/Getty Images)

WASHINGTON — President Donald Trump announced Monday that his administration believes it’s found one contributing factor of autism and a possible treatment, though experts have said such claims are inconclusive and not backed by scientific evidence.

Trump and officials from his administration said during a press conference the Food and Drug Administration will move to update the label on Tylenol, also called acetaminophen, to reflect their concerns that it could potentially be one of the environmental causes of autism. Numerous medical organizations and the manufacturer say there is no proven link.

The FDA will also publish a notice in the Federal Register to change the label on leucovorin, a pharmaceutical intended to counteract the negative effects of certain cancer medications, so that doctors can prescribe it as a potential treatment for autism. 

“They are strongly recommending that women limit Tylenol use during pregnancy unless medically necessary,” Trump said. “That’s, for instance, in cases of extremely high fever that you feel you can’t tough it out. You can’t do it. I guess there’s that.”

Health and Human Services Secretary Robert F. Kennedy Jr. said the FDA “is responding to clinical and laboratory studies that suggest a potential association between acetaminophen use during pregnancy and adverse neurodevelopmental outcomes, including later diagnosis for ADHD and autism.”

Kennedy noted, however, that the FDA recognizes that Tylenol “is often the only tool for fevers and pain in pregnancy, as other alternatives have well documented adverse effects. 

“HHS wants, therefore, to encourage clinicians to exercise their best judgment in the use of acetaminophen for fevers and pain in pregnancy by prescribing the lowest effective dose for the shortest necessary duration and only when treatment is required.”

Kennedy, an environmental lawyer with no medical or research training, said in April the department will shift its research into autism toward potential environmental causes, and pledged to have “some of the answers by September.”

‘Not a single reputable study’

Trump and Kennedy’s announcement was met with deep skepticism. 

Alison Singer, president of the Autism Science Foundation, wrote in a statement released Monday that she’s “unsure why this announcement came today and how the conclusions were drawn.”

“No new data or scientific studies were presented or shared. No new studies have been published in the literature. No new presentations on this topic were made at scientific or medical conferences,” Singer wrote. “Instead, President Trump talked about what he thinks and feels without offering scientific evidence. He said ‘tough it out,’ meaning don’t take tylenol or give it to your child. It took me straight back to when moms were blamed for autism. If you can’t take the pain or deal with a fever, then it’s your fault if your child has autism. That was shocking. Simply shocking.”

American College of Obstetricians and Gynecologists President Dr. Steven J. Fleischman wrote in a statement the Trump administration’s claim about Tylenol is “not backed by the full body of scientific evidence and dangerously simplifies the many and complex causes of neurologic challenges in children.”

“In more than two decades of research on the use of acetaminophen in pregnancy, not a single reputable study has successfully concluded that the use of acetaminophen in any trimester of pregnancy causes neurodevelopmental disorders in children,” Fleischman wrote. “In fact, the two highest-quality studies on this subject—one of which was published in JAMA last year—found no significant associations between use of acetaminophen during pregnancy and children’s risk of autism, ADHD, or intellectual disability.”

ACOG writes on its website that women who experience headaches during pregnancy can use over-the-counter medications like Advil, also called ibuprofen, and Aleve, also known as naproxen, “for migraines that don’t get better with acetaminophen, but only in the second trimester and only for 48 hours or less at a time. It’s not clear if NSAIDs are safe for a fetus during the first trimester. Taking NSAIDs during the third trimester may lead to birth defects.”

Oz wants state Medicaid programs to cover prescriptions

At the press conference, FDA Commissioner Dr. Marty Makary said leucovorin could possibly help alleviate low folate levels, which may be one potential factor in autism. 

“Autism may also be due to an autoimmune reaction to a folate receptor on the brain not allowing that important vitamin to get into the brain cells,” Makary said. “We have a duty to let doctors and the public know we are going to change the label to make it available. Hundreds of thousands of kids, in my opinion, will benefit.”

Administrator of the Centers for Medicare and Medicaid Services Dr. Mehmet Oz said the agency will try to ensure anyone on a government health program can have a prescription for leucovorin covered. 

“Over half of American children are covered by Medicaid and CHIP,” Oz said. “Upon this label change, state Medicaid programs in partnership with CMS will cover prescription leucovorin around the country. It’s yours, but you have to go to a doctor to get a prescription, because they know your child, they know you and they know the medication.”

Oz said he believed that “private insurance companies will rapidly follow our lead if they have not already done so.”

CMS, he said, is also contacting state governments to aid the Trump administration in studying the use of leucovorin as a possible treatment for autism. 

“Collecting real-world data, which is what many of you have been asking us to do in the community, is fast, it is life-saving and we’ll get answers based on what happens over the next few months with this approach,” Oz said. 

NIH research projects picked

Director of the National Institutes of Health Jay Bhattacharya said his agency has selected 13 projects to receive a share of $50 million to look for autism’s root causes and therapies. 

“The studies feature a new kind of science called exposomics, where scientists consider environmental and medical factors, nutrition, events during pregnancy in combination with biology and genetics to answer vital questions about autism,” Bhattacharya said.

Bhattacharya also gave a brief description of autism spectrum disorder, noting it “encompasses a very wide range of symptoms, ranging from mild difficulties in social interactions to profoundly autistic children who experience severe disabilities in speech and behavior.

“Given this wide range of symptoms across the spectrum, it seems certain that there will be a wide range of biological contributors to explaining the cause.”

‘Findings are not entirely consistent’

The Autism Science Foundation wrote in a statement released earlier this month that “low maternal folate levels during early pregnancy have been linked in several studies to an increased risk of autism in children, though findings are not entirely consistent.”

“Data suggesting that leucovorin may be effective come from four small randomized controlled trials, all using different doses and different outcomes, and in one case, reliant on a specific genetic variant,” the Autism Science Foundation notes. “This science is still in very early stages, and more studies are necessary before a definitive conclusion can be reached.”

As for Tylenol, the Society for Maternal-Fetal Medicine released a statement earlier this month that it “continues to advise physicians and patients that acetaminophen is an appropriate medication to treat pain and fever during pregnancy.”

“At this time, the weight of scientific evidence that acetaminophen use during pregnancy causes an increased risk for autism or ADHD is simply inconclusive,” SMFM President Sindhu K. Srinivas wrote in the statement. “In maternal-fetal medicine, as in all of medicine, our recommendations are based on an evaluation of rigorous research and data, clinical expertise, and our patients’ values and preferences.” 

The statement goes on to say that “untreated fever and pain during pregnancy carry significant maternal and infant health risks. Untreated fever, particularly in the first trimester, increases the risk of miscarriage, birth defects, and premature birth, and untreated pain can lead to maternal depression, anxiety, and high blood pressure.” 

Former Chief Medical Officer at the Centers for Disease Control and Prevention Dr. Debra Houry, who resigned from the agency earlier this year, said on a call with reporters before the announcement that she was concerned the conclusions will be premature and not based on solid science. 

“As of three weeks ago, we hadn’t seen evidence that acetaminophen was linked with autism, so it’s curious to know how quickly that was developed,” Houry said. 

Tylenol has information on its website rebutting the assertion that its product has been conclusively linked as a contributor to autism diagnoses. 

“Credible, independent scientific data continues to show no proven link between taking acetaminophen and autism,” its website states. 

The company adds that the best advice is for people to talk “to your healthcare professional before taking or administering acetaminophen.”

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