Trump, RFK, and the Autism Dilemma
Kennedy and the president-elect are asking why more kids like mine are disabled by autism. They have the power to find real answers—and it’s not due to vaccines.
Whatever you
may think of Donald Trump and Robert F. Kennedy Jr., let’s give them credit for
being essentially the only politicians to invoke an alarming and shadowy topic
few want to acknowledge: the crisis of America’s rising rates of autism.
And with the
news that Kennedy is going to be Trump’s nominee to head the Department of Health and
Human Services, there will be an opportunity for them to act upon their
concern. But the peril is that, given Trump and Kennedy’s history of blaming
vaccines, they might continue down this discredited path.
The
once-rare diagnosis of autism now consumes the lives of ever-growing numbers of
U.S. families—including mine. But autism has become so mired in controversy
that wary politicians tend to look away. When comedian Dave Smith recently
asked this unfunny question about Trump and Kennedy—“Why are they the only ones
who are talking about this?”—his remarks on Instagram were viewed 3.7 million
times.
This crisis
urgently needs to be addressed, not just because children with autism and their
families need research, hope, and help but because all of society is affected
by a growing cohort of young adults who will require lifetime care. The numbers
are astonishing and irrefutable.
An autism
diagnosis was extremely rare in the 1960s to early 1980s, in the range of 0.01 to 0.05
percent of all children. Then, in the early 1990s, clinics and schools
began to notice an inexplicable surge of cases. A 1996 Centers for Disease
Control and Prevention surveillance conducted in response to national concerns found
a prevalence of 0.42 percent of 8-year-old children in
the Atlanta area. Starting in 2000, the CDC undertook rigorous multisite
studies using consistent methodology. It first found that 0.67 percent
of 8-year-olds had autism, followed by steady increases thereafter: 1.13
percent in 2008, 1.85 percent in 2016, and 2.76 percent in 2020.
The latest U.S. federal agency surveys now identify more than 3 percent of children
ages 3 to 17 as having autism—at least a 60-fold increase from 50 years ago.
And some studies report even higher rates: For example 4.6 percent of 4-year-olds in San Diego County in
2020.
No matter
the magnitude of each successive increase, the media often issues the reassurance that the rise is not real, but a function
of more recognition and of broader definitions of the condition. But Kennedy,
who is 70 years old, made a salient observation last
year in an interview: “I have never in my life seen a man my age with
full-blown autism, not once. Where are these men?”
The truth is, not a single study has identified them in any appreciable numbers. For example, the California Department of Developmental Services, well-known for its robust data on the more disabling forms of autism, counts a mere 60 cases of autism in residents born in 1954—Kennedy’s birth year. Compare that to 5,163 cases identified in kids born in 2010. It’s important to note that this system has not expanded its eligibility criteria and, in fact, enacted more stringent requirements in 2003. It has seen its overall autism caseload soar from about 3,200 in 1989 to about 190,000 today.
I know,
because I have two profoundly autistic children who are now young adults. My
daughter Sophie is 18 and lives with my husband and me. Our son Jonathan, 25,
lives a few minutes away and is aided by us and paid staff. They cannot talk,
read, write, or follow even simple directions, like how to draw a smiley face,
change their clothes, prepare food, or use a television.
Autism is on
a spectrum, and I accept that some highly verbal but socially awkward children
who might have been called “quirky” in another era may be diagnosed as autistic
today. But there also is no question that the population of substantially
disabled children like mine, children whose problems could not have been
overlooked by families and schools, has been surging. Even when one restricts
autism to its most stringent definition, called profound autism, with IQs under
50 and minimal language, one still sees prevalence nearly doubling from 0.27 to
0.46 percent of 8-year-olds in the U.S. between just 2000 and 2016, according
to a CDC study.
While RFK
Jr. and Trump are right to say unraveling the causes of autism should be a
public health priority for a second Trump administration, they are deeply wrong
to invoke the discredited idea that childhood vaccines could be a
culprit. As explained by Dr. Richard Besser, the former acting
director of the CDC, the specter of reduced vaccination rates would pose an
intolerable risk to public health, especially the health of children. It would
also do nothing—nothing—to reduce the incidence of autism.
How do we
know vaccines cannot be causing the autism increase? Let me count the
ways:
- We know that a hallmark of
autism is dysregulation of brain development starting in the prenatal period.
Childhood immunizations simply cannot explain what goes wrong during
gestation.
- There is not a single ingredient
in vaccines that can cause childhood brain development to go awry, and no
animal study shows links between vaccines and the abnormal brain
development seen in autism.
- There is no plausible reason
vaccines could explain autism’s strong heritability (e.g., sharply increased incidence
among siblings), or its strong male-to-female ratio of about 4 to 1.
- The vaccine schedule cannot
possibly explain the steadily accelerating rates over time.
- And most importantly,
every epidemiological study on the topic has confirmed
zero association between vaccination status and the development of
autism.
Two months
ago, Trump
pledged to establish a panel of experts who will work with RFK Jr. “to
investigate what is causing the decades-long increase in chronic health
problems and childhood diseases, including autoimmune disorders, autism,
obesity, infertility, and many more.”
If this effort takes shape, they should listen to devoted and meticulous scientists like Rutgers University’s Walter Zahorodny, who can share his quarter-century of experience tracking autism’s ascendance using consistent diagnostic criteria. He observes that he has met no one in the clinical field or education system “who doubts this is a true increase.” At the same time, they must listen to experts like Dr. Paul Offit, who can dispel any lingering impulse to blame vaccines.
The Trump
team would also do well to undo the complacent approach of the Biden
administration. Instead of pushing for vigorous inquiry into causes and
possible prevention of autism, the current administration let itself become
part of an identitarian movement that celebrates autism. The
federal Interagency Autism Coordinating Committee often acted as Orwellian language police, downplaying the disabling
aspects of autism and the very desperate needs of families. The National
Institutes of Health even proposed to remove “reducing disability” from its
mission statement, expressing concerns about “ableism.”
President
Joe Biden himself overrode the traditional “Autism Awareness Day” to proclaim
it as “World Autism Acceptance Day,” with the Department of Health
and Human Services declaring all of April as “Autism Acceptance Month.” This resulted in a stream
of federal messaging romanticizing this often
horrifically debilitating disorder, one that is projected to soon burden the country with $1 trillion a year in
expenses.
But the last
thing we need in addressing the national emergency of autism is more nonsense
about vaccines or heavy metals—another RFK Jr. discredited favorite. And we
certainly don’t need more duplicative
federal efforts that fail to advance our understanding of
autism.
Instead, the
next administration should stick to facts and logic, while taking well-informed
risks on neglected avenues for research. For example, I have long advocated for
research on new concepts about autism’s origins. This relates to
how toxic exposures impact not the fetus, but the parents’ germ cells—that is,
their eggs, sperm, and precursor
cells. There is vast scientific territory open for exploration here.
Let’s dive in. Let’s solve this. Let’s, yes, Make America Healthy Again. RFK Jr. and Trump are right to shine a spotlight. Three decades is far too long to go without answers.
Post a Comment