The Day Our Government Told Mothers They Caused Their Children's Autism
"Don't take Tylenol, tough it out." Yesterday's press conference wasn't just bad science—it was dangerous advice wrapped in mother-blaming
In my last article, I used the parallel to the Seven Dwarfs to capture my sentiments watching the ACIP meeting unfold. Unfortunately, I can't muster up much levity right now. Yesterday's press conference on autism made me feel immense sadness, anger, and fear. Is there a darker dwarf spinoff?
At times, I had to remind myself that, no, this was not a Saturday Night Live skit. These were our nation's federal health leaders, standing up on a podium, broadcasting to the entire world that mothers caused their children's autism, that pregnant women should tough out fevers, that we are pumping our kids with scary chemicals that their bodies can't handle, and so many more falsehoods that I genuinely lost count. Perhaps it sounds dramatic, but the reality is that I watched with my jaw on the floor and tears streaming down my face.
My fellow science communicators and I were flooded with questions from moms riddled with guilt, pregnant women riddled with fear and anxiety, and autistic people who felt caught in the crossfire. I discussed this on ABC News yesterday, but I wanted to expand on what we're telling families. So a group of us put together some messages that I thought we'd share here (shoutout to Dr. Liz Marnik, Edward Nirenberg, Dr. Annicka Evans, and Dr. David Higgins).
The Messages That Need to Be Heard
To Parents Drowning in Guilt
We're hearing from so many parents asking if they caused their child's autism by taking Tylenol (trade name of a medicine that contains acetaminophen). The answer is no.
The largest study to date, which analyzed 2.5 million children, found no increased likelihood when properly accounting for genetic factors. Autism is primarily genetic—established before birth through complex factors beyond anyone's control. If you took acetaminophen, you took a medication that is deemed safe by every major medical organization for the management of pain or fever during pregnancy (things that could have potentially harmed your pregnancy if left untreated).
This is not your fault. Each of us does the best we can with the information we have at the time—and the data say that you did nothing wrong and, in fact, potentially protected your baby from the harmful effects of a fever in pregnancy.
To Pregnant Women Being Told to "Tough It Out"
You do NOT need to "tough out" a fever during pregnancy. Unlike the disputed claims about acetaminophen, the risks of untreated fever during pregnancy are well-established. Fevers above 100.4°F in the first trimester are proven to increase the risk of adverse birth outcomes. This is well-established science with decades of evidence—not speculation.
A 2014 systematic review and meta-analysis published in Pediatrics found that maternal fever was associated with an increased risk of several adverse birth outcomes: nearly a threefold higher risk of neural tube defects (OR=2.90, 95% CI: 2.22-3.79), almost double the risk of oral clefts (OR=1.94, 95% CI: 1.35-2.79) and 1.5 times the risk of congenital heart defects (OR=1.54, 95% CI: 1.37-1.74). In addition:
With one exception, most reviewed studies concluded fever severity (e.g., highest temperature reached) did not change the risk of these outcomes.
In most cases, the use of anti-fever medications (like acetaminophen) actually removed the risk of adverse birth outcomes due to maternal fever.
While debates continue about acetaminophen's theoretical risks, letting a high fever go untreated poses known, immediate dangers to your pregnancy. Talk to your OB/GYN about safe treatment options.
To the Autistic Community
You are valuable, loved, and important members of our society whose neurodiversity enriches our world. We are deeply sorry that your lives and experiences are being exploited to spread lies and fear. You deserve respect, acceptance, and support. You deserve not to be used as pawns in political theater that ignores your voices while claiming to speak for you.
Autism isn't a tragedy—the constant dehumanization and devaluation of autistic people is.
What the Science Actually Says
A comprehensive briefing from science communicators is forthcoming, but I wanted to share what we know now:
About Acetaminophen and Autism
The centerpiece of the administration's claims appears to be a review of studies on acetaminophen taken during pregnancy. But as I explored in my previous analysis, the evidence is far from conclusive:
The Swedish study of 2.5 million children initially found small associations (5-7% increased likelihood), but these completely disappeared when comparing siblings. (An association in science simply means that there seems to be some kind of connection between two things- it does NOT mean that one thing causes another. There could be a third thing that caused both of the first two, which is known as a confounder.)
In the sibling analysis, there was no dose-response effect—kids exposed to high doses had the same autism rates as unexposed kids. If there were an actual link between acetaminophen and autism, we would expect the probability of having autism to increase with increasing levels of exposure to acetaminophen.
The centerpiece of the administration's claims appears to be a systematic review of 46 studies examining acetaminophen use during pregnancy and neurodevelopmental outcomes. This review, published in Environmental Health in August, compiled studies with wildly different methods, populations, and ways of measuring both exposure and outcomes—making it impossible to perform a proper meta-analysis where data could be meaningfully combined. The review authors themselves stated they "cannot answer the causation question.
The fundamental issue here is that association is not causation. When genetics is properly accounted for, the supposed link vanishes. As autism experts explained in the New York Times roundtable, the review paper's author served as an expert witness in acetaminophen litigation, and his testimony was excluded by the judge for being "scientifically unsound."
Both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) released strong statements yesterday. ACOG emphasized that "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." The AAP called the White House event "filled with dangerous claims and misleading information."
About Folate and Leucovorin
Dr. Kevin Klatt provided an excellent primer on the folate-autism hypothesis that I want to simplify here:
The administration is promoting leucovorin (folinic acid) as an autism treatment based on the idea that some autistic children might have "cerebral folate deficiency"—low folate specifically in the brain despite normal blood levels.
The reality?
Only a handful of small trials have been conducted, with 80 or fewer participants.
Effects, when found, were generally modest.
Leucovorin has never been tested head-to-head against other forms of folate.
The doses used are much higher (about 10-100 times higher) than the normal dietary intake.
The proposal of leucovorin as a treatment would only theoretically work for a small subset of autistic people with an antibody against the folate receptor (but these antibodies are not much more common in autistic people than in close relatives who do not have autism, so their meaning is not yet clear).
As Dr. Klatt emphasizes, this research is "in its infancy" and desperately needs proper funding for larger trials, not premature FDA approval. It should also be said that cerebral folate deficiency is generally believed to be extremely rare, with fewer than 20 individual cases reported in the medical literature as of 2019. It remains possible that autism may share certain features of cerebral folate deficiency, but this is not clear as of right now.
About Rising Autism Rates
The claim that autism is a "horrible crisis" with rates exploding 400% misunderstands what's actually happening. The rise in diagnoses largely reflects broadened diagnostic criteria that took effect in 2013, increased awareness and better screening protocols, and recognition of previously overlooked groups, including girls, people of color, and adults. We're not seeing more autism so much as we're finally seeing autism that was always there.
What was once called "mental retardation" or "childhood schizophrenia" is now recognized as autism spectrum disorder. The AAP adopted universal screening at 18-24 months in 2007. We've gotten better at identifying autism across the full spectrum, not just the most obvious cases. When researchers compare autism rates across generations using the same diagnostic criteria, the rates are similar, suggesting the actual prevalence hasn't changed as dramatically as the numbers suggest.
This is further supported by a 2015 Swedish study examining over one million children found something remarkable: while autism diagnoses increased substantially over a decade, the actual prevalence of autistic traits in the general population remained completely stable. This powerfully demonstrates that we're not seeing more autism—we're seeing better identification of autism that was always there. The rise in diagnoses reflects changes in diagnostic practices, awareness, and access to services, not an epidemic of new cases.
This finding is particularly compelling because it separates the actual traits from the diagnosis, showing that the underlying neurodiversity hasn't changed even as our ability to recognize and name it has improved dramatically.
Other Key Debunked Claims
Children do NOT get "too many" vaccines. Today's entire vaccine schedule contains fewer antigens (immunity-stimulating proteins) than a single old pertussis shot, while protecting against up to 18 serious diseases. The entire childhood vaccination schedule can be completed in as few as 26 vaccine doses, 19 of which are from flu. Modern vaccine engineering has created more refined vaccines that are easier on children's immune systems than ever before.
Hepatitis B is not only sexually transmitted. Babies can contract it during birth from infected mothers regardless of the mode of delivery (though the risk is lower with C-section), through household contact, or through medical procedures. The biggest risk for contracting HBV for babies is through their mother, which can happen during pregnancy and during birth, but we also have many cases where mothers were not infected and then their babies were, presumably by another member of the household. Hepatitis B virus can be infectious even at tiny doses and while it’s most concentrated in the blood, it can also show up in saliva. The birth dose is a safeguard against these situations. It is safe and has brought childhood hepatitis B infections to near-elimination.
The Amish do have autism. They're diagnosed at lower rates primarily due to a general avoidance of most modern medicine. When they do seek care, autism is found.
There is no evidence that aluminum in vaccines causes autism (and, yes, we have studied this). Extensive safety studies involving 1.2 million children consistently show vaccines with aluminum adjuvants do not increase the likelihood of autism, ADHD, asthma, and a host of other health outcomes. The doses of aluminum salts in vaccines are far below toxic levels. Vaccines do not cause autism. Full stop.
There is no single cause of autism. Autism results from complex interactions between genetic and environmental factors. Twin studies show heritability of 64-91%, meaning genetics accounts for most when it comes to autism likelihood. At least 100 genes are involved. The identified environmental factors appear to act during pregnancy—not after birth—and most cannot be readily prevented except by managing maternal fever.
Moving Forward
My colleagues and I are working on a comprehensive briefing through The Evidence Collective that will systematically debunk each falsehood with peer-reviewed evidence. But we shouldn't have to spend our time relitigating settled science while real families suffer from a lack of services and support.
What autistic people and their families actually need:
Adequate funding for special education support to help children thrive
Insurance coverage for evidence-based therapies
Support for adults transitioning out of school-based support
Respite care for families
Acceptance and accommodation in workplaces
Instead, we get political theater that resurrects zombie theories we thought were buried decades ago.
A Personal Note
As I sit here trying to make sense of how we got here, I keep thinking about all the parents who watched that press conference and are now questioning every medical decision they've ever made. To you, I want to say: You are good parents. You made the best decisions you could with the information available. Your child's autism development was not in your control.
And to my fellow scientists and healthcare providers: We have work to do. Not just in debunking falsehoods, but in making sure accurate information reaches the families who need it most. This is going to be a long fight, but it's one worth having.
Please don't let anyone make you feel guilty for following evidence-based medical guidance.
Stay Curious,
Unbiased Science
Want to support our work? The best way is to subscribe to our Substack and share our content. While all our articles are always completely free to read, paid subscriptions help sustain our in-depth reporting on public health and science topics. Thank you for considering it!
 | A guest post by
|
 | A guest post by
|
 | A guest post by
|
 | A guest post by
|
 | A guest post by
|
As a physician and parent I am horrified by these terrible actions by our government! I just subscribed to your feed to help support spreading the word of sanity! I will look to share and educate any time I can! Right now that seems like all I can do along with walking on my woods trails to calm my anger and despair:-(
I try so hard to stay out of political conversations on here, especially when here in Ireland we have our own governmental idiots, but as the mother of an autistic child my heart breaks for all those parents who went to bed last night blaming themselves...