RFK Jr. Calls for Answers on Rising Autism Rates Amid Criticism
The Trump administration recently announced initiatives aimed at addressing the perceived “epidemic” of autism spectrum disorder, including a new warning label on acetaminophen products like Tylenol. Health and Human Services Secretary Robert F. Kennedy Jr. stated that federal officials would be “uncompromising and relentless” in their search for answers regarding autism and its increasing diagnoses. However, many scientists argue that the evidence supporting such claims is weak and that important factors are being overlooked.
Kennedy, a longstanding advocate for investigating external influences on autism, pointed out that the rise in diagnoses among U.S. children must correlate with increased exposure to various factors, such as drugs, chemicals, or vaccinations. “We need to move away from the ideology that the relentless increases in autism prevalence are simply artifacts of better diagnoses or changing criteria,” Kennedy asserted in April.
Data clearly shows that autism spectrum disorder rates have climbed significantly in the U.S., from 1 in 150 8-year-olds in 2000 to 1 in 31 in 2022, according to the Centers for Disease Control and Prevention (CDC). While Kennedy’s observation is accurate, health professionals stress that understanding this increase requires acknowledging two crucial points: the diagnostic criteria for autism have expanded and the frequency of diagnosis has improved.
Understanding the Diagnostic Changes
The term “autism” first appeared in the literature shortly after World War II, when two psychiatrists described different groups of children exhibiting similar behaviors. In 1938, Austrian pediatrician Hans Asperger noted children with unique social behaviors and intense interests, while U.S. psychiatrist Leo Kanner documented children who were socially withdrawn and sensitive to sensory input.
For decades, children displaying traits of autism were often misclassified under outdated diagnoses, such as “mental retardation” or “childhood psychosis.” Autism was officially recognized as a distinct diagnosis in the 1980 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), defining it as a condition involving impaired communication and social interaction. Over time, the DSM’s definition has become broader, incorporating a wider range of behaviors.
A significant change occurred in 1994, when the DSM’s fourth edition included additional behaviors associated with autism. An uncorrected typo in the definition further contributed to rising diagnoses, leading to a significant increase in reported cases. By 2000, after the CDC began tracking autism rates, the prevalence had grown to 1 in 150 children.
Screening and Diagnosis Improvements
Recognition and diagnosis of autism underwent critical advancements with the American Academy of Pediatrics’ recommendation in 2007 to screen all children for autism between 18 and 24 months during routine check-ups. Prior to this, many pediatricians lacked familiarity with early indicators of autism, leading to inconsistent diagnoses.
In 2013, the DSM’s fifth edition combined various autism-related conditions into a single diagnosis: autism spectrum disorder (ASD), expanding the definition to include a broad spectrum of social and communication differences. This change allowed for better identification of children from various backgrounds, addressing disparities in autism diagnoses.
A notable shift has been observed in the demographics of diagnosed children. Recent CDC surveys indicate that autism prevalence is now higher among children of color than among white children, marking a significant change in diagnostic patterns. According to Kristina Lopez, an associate professor at Arizona State University, this increase is a positive sign of improved diagnostic practices among Latino and other underserved communities.
Kennedy’s assertion that most autism cases are severe is contradicted by research. A 2016 review of CDC data indicated that approximately 26.7% of 8-year-olds diagnosed with autism exhibited profound symptoms. The rate of children diagnosed with severe autism has remained stable, while most new cases are among those with mild limitations.
The recent focus on autism by the Trump administration has elicited mixed responses from researchers and advocates. Many have long advocated for more attention and resources for autism, but they express concern that the administration is spreading misinformation. Colin Killick, executive director of the Autistic Self Advocacy Network, emphasized the need for accurate information and policies that support the autism community rather than propagate fear.
As discussions surrounding autism continue, the need for a nuanced understanding of diagnosis and prevalence is increasingly critical. While the numbers reflect a growing awareness and improved diagnostic capabilities, attributing the rise solely to external factors without considering the expanded definitions and increased screening risks perpetuating misconceptions about autism.
This article was produced with the support of the USC Annenberg Center for Health Journalism’s National Fellowship’s Kristy Hammam Fund for Health Journalism.
