RFK Jr's press conference today — some good, some bad, some ugly

We should be grateful that the health secretary is pounding the podium about the reality of the epidemic. We should only hope he opens his mind to better ideas about causation.

Today health secretary Robert F Kennedy, Jr. held a most unusual press conference, on the heels of the publication of CDC report that autism rates in 8 year-olds had reached 1 in 31.

He explained — quite rightly — that we need to dispense with the conventional wisdom that our autism surge is due to awareness or diagnostic factors. This trope has been repeated ad nauseam for the past two decades, untethered however from the actual data.

The reality of the autism increase is so huge, so obvious, so sustained since the 1990s, it’s ludicrous to deny it. He went over several lines of data, but there’s much much more evidence that he did not address, with more time he could have built an even more solid case. But suffice it to say that about 1.3% of US eight-year-olds now have autism with intellectual disability (3.22% have autism at any level). If you want to argue this is also the historical norm, but we just missed 90% of the cases, please present data to support that argument. But that data does not exist and RFK Jr. knows it.

He invited Dr. Walter Zahorodny or Rutgers University, director of the CDC New Jersey autism surveillance, to speak about his views on the autism surge. (Please see my Substack from yesterday which includes extensive remarks from him.) He explained his experience seeing autism rise from being rare to pervasive in the New Jersey communities, adding that “autism prevalence has increased in all the states in the network,” in special ed and surveys.

“Better awareness of autism does not drive autism to increase 300% in 20 years.” And he said in the future rates can only be higher. He said autism deserves to be treated “as an urgent public health crisis.” Amen to that.

(Note: Even when limited to cases of autism with intellectual disability, the CDC autism prevalence rates have increased nearly 300%, from 0.43% in the 2008 cycle to 1.28% of eight-year-old children in the 2022 cycle. This dramatic increase in very serious neurodevelopmental disability cannot be due to awareness.)

Truly we are well past unsustainable rates of autism. But rates could be 10%, 20%, or 30% and still the media would mindlessly repeat the “better awareness” mantra.

The awful truth is that the autism explosion will exert enormous and growing burdens on our safety net systems, on our economy, on our national security. It has been crushing our schools and now it’s overwhelming our adult programs.

It’s not fun to contemplate these things, especially for someone like me who has a boundless love for and devotion to our autism community. Not to mention two very beloved adult kids with profound autism.

But progress will depend on following facts and logic, and not waving our hands about “toxins,” ultrasounds and whatever. RFK Jr. went off the rails on those points. He also described severe autism with some accuracy, though maybe exaggerating in parts, but did a disservice to those who are higher functioning by overgeneralizing the impairments.

Autism should absolutely be a priority at the NIH. But whether investigations can be carried out competently or not is another question. Keep in mind the two most pressing questions for autism research: (1) its missing heritability, and (2) its roots in dysregulation of transcription during early brain development. Our work should start there, not old disproven theories.

Check out more of my thoughts here on Substack and at Jillescher.com.