Power shifts in the politics of autism

After decades of being on the outside looking in, those who believe autism is driven primarily by environmental factors are now not only on the inside but sitting at the table of federal power, and they are reshaping the national debate over the disorder in ways that are quaking through science, medicine, the media, and public policy.

Still, that doesn’t mean that those who believe autism is largely genetic are giving up.

They are organizing, press-releasing, and finger-wagging, and more, critics say, they are backed by some of the most powerful institutional and pharmaceutical interests in the country.

At the heart of the controversy is a dramatic shift in federal policy under U.S. Health and Human Services (HHS) secretary Robert F. Kennedy, Jr., who has moved aggressively to redirect research priorities, rebuild advisory bodies from the ground up, and recast autism spectrum disorder (ASD) not only as a full-blown public health crisis but as a preventable, environmentally driven epidemic.

The result is a straight-up confrontation between the federal government and the science establishment, with each side battling to control the broader public narrative and the narrower but richly funded science behind it.

A shift in power

The pivot in government policy began with Donald Trump’s re-election as president in November 2024 and his subsequent selection of Kennedy as HHS secretary.

Kennedy has long voiced concerns about the safety and efficacy of vaccines in general, as well as their role in autism causation, and, at his first major press conference as secretary in April 2025, he made clear that his approach to autism would depart sharply from that of prior administrations.

“This is part of an unrelenting upward trend,” Kennedy said then, pointing to new federal data showing autism prevalence rising from 1 in 150 children two decades ago to 1 in 31 today.  “In all the core states, the trend is consistently upward. And most cases now are severe. So about 25 percent of the kids who are diagnosed with autism are nonverbal, non-toilet trained, and have other stereotypical features, such as head-banging, tactile and light sensitivities, stimming, and toe-locking.”

Kennedy said the rise in those numbers could not possibly have been due to improved diagnosis or broader definitions, but rather to a real and accelerating crisis.

“In 1987, there was another exhaustive study, a peer-reviewed study in North Dakota set out to count every child in the state with a pervasive developmental disorder, including autism,” Kennedy recounted in that press conference. “That study meticulously combed through every record, every diagnosis, and it even conducted the in-person assessments of the entire population of 180,000 children under 18. The autism rate they found was 3.3 per 10,000. So that’s in line with the 1 in 10,000 that was found in Wisconsin 17 years earlier.”

For context, Kennedy pointed out, the previous number of 1 in 36 in 2023 was 83 times higher. At 1 in 31, it’s 98 times higher.

“In 1987, out of every 1 million kids, 330 were diagnosed with autism,” Kennedy said. “Today, there are 27,777 for every million.”

That rise could not possibly be due to better diagnosis alone, Kennedy said.

“If you accept the epidemic denier’s narrative, you have to believe that researchers in North Dakota missed 98.8 percent of the children with autism, and thousands of profoundly disabled children were somehow invisible to doctors, teachers, parents, and even their own study,” he said. “The same researchers who followed the original cohort for 12 years to double-check their number, they went back in 2000 and found that they had missed exactly one child.”

You say dim, I say wit

Doctors and therapists in the past were not stupid, Kennedy said: “They weren’t missing all these cases,” he said. “The epidemic is real.”

Kennedy and the administration cited data from the Centers for Disease Control and Prevention’s Autism and Developmental Disabilities Monitoring (ADDM) Network, which found that autism prevalence has increased nearly fivefold since the agency began tracking it in the early 2000s.  

The latest data show autism prevalence rising from 1 in 36 children to 1 in 31 in just two years; rates as high as 1 in 20 for boys nationally; even higher concentrations in certain states, including California; and a growing share of cases classified as severe or involving intellectual disability.  

Federal data reveal that almost two-thirds of children with ASD in the latest survey had either severe or borderline intellectual disability.

To Kennedy, those figures prove that the increase cannot be explained simply by better awareness or diagnosis. Instead, the secretary has repeatedly pointed to environmental exposures.

“There are many, many other studies that affirm this, and instead of listening to this canard of epidemic denial, all you have to do is start reading a little science, because the answer is very clear, and this is catastrophic for our country,” he said last April. “This is a preventable disease. We know it’s an environmental exposure. It has to be. Genes do not cause epidemics. It can provide a vulnerability. You need an environmental toxin.”

Kennedy took aim at corporate media, too, which he says has peddled epidemic denialism. 

“It’s based on an industry canard, and obviously, there are people who don’t want us to look at environmental exposures,” he said. 

Kennedy has not merely engaged in rhetorical flourish; he has undertaken a sweeping shift in federal policy and funding priorities. According to the administration in 2025, the federal government is now investing tens of millions of dollars in new research focused on environmental causes; launched the Autism Data Science Initiative, funding 13 projects totaling more than $50 million; expanded research into environmental, nutritional, and chemical exposures alongside genetics; and is using large-scale data analysis and machine learning to identify potential causal pathways.  

The initiative is explicitly designed to rebalance what Kennedy and others describe as a decades-long bias toward genetic research. Historically, Kennedy said, the amount of money and resources put into studying genetic causes, which he calls a dead end, has been 10 to 20 times that spent by NIH and other agencies to study environmental factors.

That imbalance, Kennedy argues, has delayed answers and destroyed families: “We should have had these answers 20 years ago,” he said. 

Kennedy said the government’s failure to address it or even acknowledge it is an all-around tragedy.

“This is an individual tragedy as well,” he said. “Autism destroys families. More importantly, it destroys our greatest resource, which are our children. These are children who should not be suffering like this. These are kids who, many of them, were fully functional and regressed because of some environmental exposure into autism when they were two years old, and 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, Kennedy said.

“We have to recognize we are doing this to our children, and we need to put an end to it,” he said. 

To find cause, clean house

The administration is mostly focusing on causation, but has taken steps to expand treatment options, including directing the Food and Drug Administration to recognize a pathway for using leucovorin to treat certain autism-related symptoms, particularly those tied to cerebral folate deficiency.

At the same time, federal agencies are reviewing widely used over-the-counter medications such as acetaminophen, commonly sold as Tylenol, citing studies suggesting potential links to negative neurodevelopmental outcomes, though they acknowledge conflicting evidence.  

“Given the conflicting literature and lack of clear causal evidence, HHS wants to encourage clinicians to exercise their best judgment in use of acetaminophen for fevers and pain in pregnancy by prescribing the lowest effective dose for the shortest duration when treatment is required,” HHS states.  

But perhaps the administration’s most controversial move this past year was Kennedy’s restructuring of key federal advisory bodies. In June 2025, HHS removed all 17 members of the Advisory Committee on Immunization Practices (ACIP) and replaced them with new appointees.

The Biden administration appointed all 17 ACIP members Kennedy replaced, including 13 who came on board in 2024. Those appointments would have prevented the current administration from choosing a majority of the committee until 2028. Kennedy said the Biden administration made a concerted effort to lock in public health ideology and limit the incoming administration’s ability to take the proper actions to restore public trust in vaccines.

“A clean sweep is necessary to reestablish public confidence in vaccine science,” Kennedy concluded. “ACIP’s new members will prioritize public health and evidence-based medicine. The committee will no longer function as a rubber stamp for industry profit-taking agendas. The entire world once looked to American health regulators for guidance, inspiration, scientific impartiality, and unimpeachable integrity. Public trust has eroded. Only through radical transparency and gold standard science will we earn it back.”

(A federal judge stayed Kennedy’s reconstitution of ACIP in March, but now Kennedy has rewritten ACIP’s charter in response, and that battle is being played out in court.)

The administration also revamped the Interagency Autism Coordinating Committee (IACC), a congressionally mandated body that helps set federal autism research priorities. That transformation provoked immediate backlash from the scientific community, which argued that the new appointments lacked continuity and expertise.

According to critics, the new federal committee includes members who have promoted what they describe as unsupported or controversial views on autism, including links to vaccines.

The result, they say, is a fundamental shift both in policy and in who gets to define what credible science actually is.

Scientists push back

The genetic causation movement has pushed back with a formal organizing effort. In March, a group of leading researchers and advocacy organizations announced the formation of the Independent Autism Coordinating Committee (I-ACC), designed to operate not only outside the federal structure but counterposed to it.

The group includes former members of federal autism advisory committees, National Institutes of Health officials, and prominent autism researchers.

“Scientific expertise and institutional memory are critical to developing a coordinated autism research plan,” said Dr. Helen Tager-Flusberg, a member of the new committee. “When those elements are missing, the committee cannot function as intended.”

Members say the I-ACC restores the rigor and coordination needed to accurately assess progress and ensure that evidence-based progress continues to be made. Organizers, including Tager-Flusberg, say the new committee will bring together accomplished scientific experts and stakeholders with research expertise, with the goal of accelerating scientific discovery, improving care, and positively impacting the lives of people with autism. 

Among other things, organizers say it will create a strategic plan for autism research that reflects the rapid progress and growing promise of autism science, and will report annually on the key advances in autism research across the translational continuum, including basic research on genes and cells, environmental causes, early detection, therapeutics, and services. 

Officials say the I-ACC will also follow the meeting schedule of the federally appointed IACC so it can respond quickly to any recommendations they say are not supported by science. They said the group aims to develop its own research agenda; provide annual reports to Congress; counter what members describe as misinformation; and maintain continuity with decades of prior research.

“The newly constituted Kennedy-appointed IACC represents a complete and unprecedented overhaul, with no continuity from prior committees and a striking absence of scientific expertise,” Alison Singer, president of the Autism Science Foundation and former IACC member, said. “It disproportionately represents a tiny subset of families who believe vaccines cause autism, while excluding the overwhelming majority of advocates and experienced autism researchers who support evidence-based science. The new I-ACC will ensure science, not misinformation, guides autism research.”

The “shadow” committee represents an unprecedented split in the autism research community to many observers, though, to be fair, critics of the science establishment have pointed out their significant differences for years. It’s only now that the shoe is on the other foot that the divisiveness is being noticed, they say.

For a brief period in March, two separate autism coordinating meetings were scheduled for the same day, each claiming authority over the direction of research.  In the end, only one took place.

About causation or power?

Ostensibly the dispute is about a fundamental difference of opinion over what causes autism.

Corporate researchers have long argued that autism is primarily genetic, and they point to decades of research and troves of studies, including twin research and genomic analysis. Advocates of that view are now pushing back through the I-ACC against the administration’s environmental emphasis.

They argue that environmental research should not displace “established science” but proceed alongside it. They also want that dramatic policy shifts could undermine public trust in established medical guidance.

Some Trump critics have gone further, warning that the federal approach could lead to the misuse of health data or to poorly designed studies, while others have criticized what they describe as the politicization of science.

Among those critics are the past two former directors of the National Institute of Mental Health (NIMH), Tom Insel and Joshua Gordon, both of whom chaired the IACC during tenures spanning 2002 to 2024 and are now I-ACC members. 

Gordon, who most recently led IACC for eight years beginning in 2016, said the lack of appropriate representation of scientists and advocates from nongovernmental organizations has caused concern that the federal committee won’t carefully consider its advice.

Dolloped on top of the scientific debate is a long-running controversy over the role of pharmaceutical companies. Critics of the genetic model — and of vaccine-related research more broadly — argue that industry influence and its political agenda have shaped research priorities all along, funded many of the studies showing no link between environmental factors and autism, and suppressed alternative explanations, and with it any association with products, including vaccines, that they sell.

Federal materials cite past disclosures by researchers with ties to pharmaceutical companies, including consulting relationships and patent interests in vaccine development. To cite just one example, Dr. Pauli Offit, a former member of the federal panel before being removed by Kennedy, has both consulted with Merck on vaccine development and is a co-holder of the patent on a bovine-human rotavirus vaccine.

He also sits on the board of Singer’s Autism Science Foundation and has donated book proceeds to the group. The new independent committee also includes Jim Greenwood, the former president and CEO of the largest biotechnology trade group.

Supporters of the current administration say such conflicts underscore the need for reform.

“Today we are prioritizing the restoration of public trust above any specific pro- or anti-vaccine agenda,” Kennedy said. “The public must know that unbiased science — evaluated through a transparent process and insulated from conflicts of interest — guides the recommendations of our health agencies.”

On the other hand, many researchers argue that such claims are overstated. They say conflict-of-interest disclosures are standard practice and that regulatory systems are designed to manage, not eliminate, such relationships.

Richard Moore is the author of “Dark State” and may be reached at richardd3d.substack.com.