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As a working, board-certified general pediatrician, I can unequivocally state that there are no evidence-based, robust scientific studies demonstrating a link between autism and the appropriate use of acetaminophen (trade name Tylenol.) And as a public servant and parent of a young child, I am very careful about the statements I make as they can impact my child and so many more.
I would encourage anybody who has questions about Tylenol and autism to read the credible information found on the websites of the American Academy of Pediatrics (representing nearly 67,000 members, many of whom are board certified pediatricians) and the American College of Obstetricians and Gynecologists (that represents 62,000 members, many of whom are board-certified obstetricians and gynecologists).
It is true that the incidence of autism has increased over the years. Despite the funding cuts to many of our premier scientific research institutions, many researchers, parents and advocates continue working tirelessly to determine better ways to screen, diagnose and treat children with autism. While there have been some clear associations (e.g., advanced paternal age) with autism, we are far from and may not ever find a singular, simple causative factor.
Despite practicing for over 15 years, I remain surprised and humbled with the many ways autism can present. Sometimes the symptoms are so subtle that people (including me) would overlook them. Because of the myriad ways autism can present, my fellow pediatricians and I are advised to screen children at the 18- and 24 month visits using a evidenced based, scientifically studied screening survey.
If the results of an autism screening survey are positive for a given patient, they are often referred to a developmental pediatrician that has additional training in screening, diagnosing and treating a range of developmental conditions (including autism) that children have.
There are a range of treatment options for children who have autism. Not every therapy will benefit every patient who has autism. Part of the reason for that disconnect is that autism in one patient may appear differently compared to another patient. That is why the new terminology for autism is, “autism spectrum” given that there is a range of ways that it may appear.
As was mentioned in a previous letter to the editor in The Citizen, some people who have autism-like symptoms may benefit from leucovorin. That does not mean that every patient with autism will benefit from taking that medication. And, like acetaminophen, any decision about wither or not to give a particular medication to your child should occur between you and your pediatrician.
Applied behavioral analysis (ABA) is one therapy that has been shown to benefit many children who have autism. During Autism Acceptance month last year I highlighted the difficulty in obtaining this therapy-based, non-medical approach to help children with autism realize their full potential.
There are nearly one million children who have autism and receive Medicaid. One can only hope that proposed changes to Medicaid do not negatively impact the access to beneficial therapies for those children. Part of the 2025 Budget Reconciliation Act would be to implement Medicaid adult work requirements. The proposed work requirements may reduce the number of eligible people enrolled in Medicaid. Having an uninsured parent increases the likelihood that children will be uninsured.
As a parent, pediatrician and public servant, I am clear about what I do and don’t know. While I (and we) may not know what causes all forms of autism, I do know that taking Tylenol at the appropriate dose and interval does not cause autism.
I also know that children with autism who are diagnosed early and receive the appropriate scientific, evidence-based interventions can realize their full potential. We collectively know that legislation that limits health insurance access will necessarily limit the number of people (including children) who can receive the therapies they need. So let us work together to ensure that every child gets the health care they deserve.
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