In the past decade, we have seen a strong increase in the prevalence of autism. According to a recent surveillance report from the U.S. Centers for Disease Control and Prevention (CDC), an average of 1 in 31 children who turned eight in 2022 were identified with autism. This increasing trend has led to much debate regarding possible exacerbating factors, one of which is the usage of medications during pregnancy. Former President Donald Trump has even fanned the flames of Tylenol panic, claiming that it causes autism. The CDC’s alarm has led to a split response from health advocates and health organizations.
The CDC will announce the next report on autism diagnosis rates in 2025. This report will provide a better picture of the scope of this escalating public health threat of autism. The fight really picked up when Trump announced his intention to change the black box warning label on acetaminophen, or Tylenol. He wanted to add a section detailing its purported dangers. The Trump administration had seen the start of the approval process for leucovorin. The drug — long an essential component of cancer care — may offer a cure for a subset of children with autism. Experts are warning that the evidence behind leucovorin’s purported effectiveness is scant at best.
The Rise in Autism Diagnoses
Autism spectrum disorder (ASD) has gained much attention and awareness in recent decades. As you likely know, the CDC has recently concluded that autism diagnoses are on the rise. In 2022, that number was as high as one in 31 eight-year-olds. This startling statistic highlights the need to do more research into the causes of autism and how best to treat it.
Even with the jump in diagnoses, scientists are quick to stress that genetics are probably the biggest factor when it comes to the development of autism. Multiple studies have suggested a gene-environment interaction, with multiple genetic factors contributing to the disorder.
Understanding Autism
Amidst this backdrop, clinicians, educators and public health officials are calling for a clearer, broader perception of autism. The American Academy of Pediatrics notes, “Regarding autism, we know it is complex, highly variable and increasingly linked to genetics.” They stress that there is no singular cause or universal treatment for autism, which complicates the narrative surrounding medication use during pregnancy.
The Controversy Over Tylenol
Former President Trump’s claims linking Tylenol use during pregnancy to autism have sparked widespread debate among medical professionals and researchers. Trump stated, “You know, I’m just making these statements from me,” highlighting his personal stance rather than relying solely on medical studies.
Public health advocates have forcefully pushed back on these claims. The American Psychiatric Association emphasizes that “a strong base of evidence shows that acetaminophen, when taken as directed, is safe for use during pregnancy.” They caution on broad extrapolation from small or preliminary studies. Rather, they feel that medication decisions should be made jointly between patients and their healthcare providers.
Dr. Steven Fleischman expressed grave concerns about the implications of Trump’s comments: “Suggestions that acetaminophen use in pregnancy causes autism are not only highly concerning to clinicians but irresponsible when considering the harmful and confusing message they send to pregnant patients.” He noted that these types of announcements could harm public health without a strong scientific justification.
Additionally, Trump has made efforts to highlight dangers associated with Tylenol. To date, no independent public study has shown a direct causal link between acetaminophen use during pregnancy and the development of autism. For example, the Food and Drug Administration (FDA) admits on its own website that numerous studies found links. So far, they haven’t been able to prove any causal connection.
Leucovorin as a Potential Treatment
Some of that buzz has been created by the Trump administration’s mission to tout leucovorin as a cure for autism. At the same time, calls to ban Tylenol have taken off. Leucovorin has demonstrated early promise in small studies, but experts are warning against the use of leucovorin as a treatment option.
The Coalition of Autism Scientists has criticized the promotion of leucovorin as a cure, stating, “The data cited do not support the claim that Tylenol causes autism and leucovorin is a cure.” They contend these misleading claims are scaremongering at best. In addition, they can provide misleading optimism as well when facing the challenges autism presents.
Leucovorin is best known for its use in cancer treatment. We require much more rigorous research to verify it is effective and safe for use in treating autism. Experts like Oppenheim stress that whatever benefits are determined to exist should be considered within a larger context and acknowledgment of the complex nature of autism.
