RFK pushes to find ‘environmental’ cause of autism, calls rising rates an ‘epidemic’

Health and Human Services Secretary Robert F. Kennedy Jr. Wednesday declared that autism is a rapidly growing “epidemic” in the U.S. and vowed to identify the “environmental toxin” he says is to blame.

He noted that autism incidence in the U.S. has increased from 1 in 36 children in 2020 to 1 in 31 in 2022, according to a report released Tuesday by the Centers for Disease Control and Prevention on the prevalence of autism.

“This is part of an unrelenting upward trend,” Kennedy told reporters during a news conference Wednesday at HHS. “Overall autism is increasing in prevalence at an alarming rate.”

Citing much lower rates in earlier decades, Kennedy pushed back against the idea that the increases “are simply artifacts of better diagnoses, better recognition or changing diagnostic criteria,” adding “the epidemic is real.” He said HHS is committed to investigating environmental causes of autism, calling it “a preventable disease.”

Within two to three weeks, the agency will announce a series of new studies “to identify precisely what the environmental toxins are that are causing” autism, he said, adding “we’re going to get back to it with an answer to the American people very, very quickly.” On Tuesday HHS announced it expects to begin to have answers by September.

Some independent experts and advocates say that’s not nearly enough time to design and conduct a good-quality study that could produce a reliable answer.

Kennedy drew a stark contrast between his proposed approach and earlier research. “The amount of money and resources put into studying genetic causes, which is a dead end, has been historically 10 to 20 times the amount spent by [federal agencies] to study environmental factors…. And that’s where we’re going to find the answer.”

In the past, Kennedy has made statements linking autism with vaccines, an idea that has been thoroughly refuted.

Kennedy’s comments drew pushback from researchers who study autism as well as patient advocates. They note that years of research point to a wide variety of causes, including a combination of genetic, biological and environmental factors.

Kristyn Roth, chief marketing officer for the Autism Society of America, told NPR her organization and other leading disability groups agree that there is a need for more autism research. “However, it has to be rooted in science and facts,” she said. “And to definitively say that autism is caused by an environmental factor or toxin is not rooted in known science right now.”

It’s very unlikely that autism is caused by “one thing,” said Catherine Lord, a professor of human development and psychology at the David Geffen School of Medicine at UCLA via email.

Zachary Warren, a pediatric psychiatrist and autism researcher at Vanderbilt University agrees. “We may have hundreds, if not thousands, of different neurogenetic factors that in combination with complicated environmental interactions influence presentations of autism,” he said via email.

“As a clinician, I wish I had better — and quite frankly simpler — answers for my families,” he added. “But autism isn’t a single thing, it is a word we use in an attempt to capture a spectrum of behavioral strengths, differences, and vulnerabilities in order to help optimally support children.”

Lord said the focus on discovering autism’s causes is a distraction from the “many things we could do now to help the children and adults and their families with autism now.” This line of research, she says, won’t help clinicians “do a better job supporting the strengths and challenges autistic people have every day.”

The CDC report released this week indicates that better screening may play a role in increased prevalence. The authors note that differences in the prevalence across communities “might be due to differences in availability of services for early detection and evaluation and diagnostic practices.”

Dr. Sara Swoboda, a primary care pediatrician in Idaho and a member of the American Academy of Pediatrics Subcommittee on Autism told NPR that pediatricians are “actually encouraged” by the report’s finding “because we know that we have gotten so much better at recognizing and identifying autism in children,” including in communities that historically didn’t have good access to autism evaluations, she said.

But one of the reports’ authors, Walter Zahorodny, of Rutgers New Jersey Medical School, speaking at Kennedy’s press conference Wednesday, said “autism prevalence has increased very dramatically.”

“There is better awareness of autism but better awareness… cannot be driving a disability like autism to increase by 300% in 20 years,” the increase seen in New Jersey, he said.

He called autism “an urgent public health crisis” and said the CDC data suggest “future rates can only be higher.”

Swoboda disagrees. “In pediatrics, we really recognize that this is not an epidemic,” she said. “This is just us doing a better job of identifying autistic children that have existed before.”

Some of Kennedy’s remarks Wednesday troubled Roth of the Autism Society of America.

Speaking of kids with autism, Kennedy said “these are kids who will never pay taxes. They’ll never hold a job. They’ll never play baseball. They’ll never write a poem. They’ll never go out on a date. Many of them will never use a toilet unassisted.”

Roth said this is stigmatizing and inaccurate. “I know plenty of autistic individuals that do all of those things, and I also know autistic individuals who may require 24/7 care,” she said. “But to dehumanize people and invalidate their experiences or generalize an entire community is incredibly harmful and offensive.

“Autistic individuals, just like all of us, deserve dignity and respect,” she added. “And that was not reflected today.”

Zoe Gross, director of advocacy at the Autistic Self Advocacy Network deplores what she calls “fear-mongering language” in Kennedy’s remarks.

“While they whip up hysteria about autism diagnosis rates, the Trump administration is attacking the rights and lives of autistic Americans on many fronts,” she said via email.

She cites proposed cuts to Medicaid, which some autistic people depend on, and the dismantling of the Administration for Community Living, a sub-agency of HHS that she says “focuses on promoting supports that allow people with disabilities to stay out of institutions.”

“Their talk of an autism ‘epidemic’ is only in service of their anti-vaccine agenda, and does nothing to benefit autistic people,” she said.