The Causations and Correlations of Autism
Katherine Scott, LMFT
Note to reader: On September 23rd, 2025 the Trump Administration and the HHS held a press conference to make an announcement about autism. We at Puzzle Peace join the thousands of other mental health professionals and organizations who were extremely alarmed at their recommendations. We found them to be inaccurate, horrifically misleading and completely unaligned with the most recent empirical research.
The quotes below labeled “DJT” are actual quotes from President Trump.
As licensed clinicians we have a ethical duty to protect and inform. This is our response.
“The Autism Fever” -DJT
I have been professionally raised on research. During high school, I completed the International Baccalaureate program which was a rigorous pre-university high school program which included a course titled ‘The Theory of Knowledge’. The core of this class demanded critical thinking about the nature of knowledge. This carried over into my studies at the University of Florida. I was a research assistant during my bachelor’s program that studied nuances of elementary learning to inform future educational needs and create research-based curriculum. Fast forward to my time during my dual master’s program, and research was the backbone of my entire profession.
Causation and correlation are two different concepts.
Correlation can indicate any possible relationship between two subjects. It could indicate that the sky is cloudy on the days the baby is constipated. However, the cloud ratio has no causation related to the baby’s bowels. Two things can rise and occur at once without the relation of causation.
There are immense dangers and consequences of relating the cause of autism to a scientific correlation at best. Researchers continually reinforce that the search for a ‘root’ cause for Autism is misguided due to the diversity and severity of symptoms, and a large range of biological contributors, and overall complexity of neurobiology (Grinker, 2025).
To reinforce this with research-based literature:
Liew, Z. et al. (2016). Prenatal use of acetaminophen and child neurodevelopment: A review. Epidemiology
- Found weak correlations with an increase in impulsive behavioral problems, but no casual proof. 64,322 live-born children were a part of the study.
Ystrom, E., et al. (2017). Prenatal exposure to acetaminophen and risk of ADHD. Pediatrics.
- A correlation in an increase in impulsive ADHD symptomatology indicated, no causation identified with Autism. 112,973 children participated within the study.
Prada, D. et al. (2025) Evaluation of the evidence on acetaminophen use and neurodevelopmental disorders using the Navigation Guide methodology.
- The review’s results were too inconsistent to perform a meta-analysis. A quote included within this study states “cannot answer the question about causation”.
The women in these studies were not considered for the following: likelihood of infections, chronic pain, ADHD, Autism, or psychiatric conditions.
Ahlqvist VH, et al. “Acetaminophen use during pregnancy and children’s risk of autism, ADHD, and intellectual disability.” JAMA.
- Swedish researchers conducted a study including 2.5 million children. When siblings were compared, meaning one exposed, one not to control for genetics and family environment. The correlation nullified indicated zero increased likelihood.
- The study reports “NIH-funded research in siblings finds previously reported connections are likely due to other underlying factors.”
“You know, it’s artificially induced”-DJT
In reality, Autism is immensely complex. Claiming a single cause is harmfully oversimplifying a complex medical reality. It has a strong genetic component, with 100+ genes having been identified as of present day. One significantly large study across 5 countries including 2,001,631 individuals concluded that upwards of 80% of those with Autism are influenced by genetic factors (Bai D et al, 2019).
Parner, ET., 2012. Parental Age and Autism spectrum disorders.
- While an association between parental age and ASD in the cohort study was identified, the risk did not act synergistically. Parental age continues to be part of research studies to explore the influence over causation of autism.
Environmental factors with an established link to a higher risk for autism include prenatal exposure to heavy metals, maternal health conditions such as diabetes or obesity, and risks during birth such as extreme prematurity. These factors interact with genetic predispositions (Karimi, 2017).
“If you can’t tough it out if it’s a problem you’re going to end up doing it.” -DJT
The History
It’s important to focus on the statistics and history of which surround the rate of Autism diagnosis. The term ‘Autism’ was first coined in 1911, however Leo Kanner created the official recognition of the neurodevelopmental disorder in 1943 (Rosen, 2021). His pool of subjects included 11 children, only 3 of which were girls. Kanner noted that there were earlier descriptions of children who likely had autism recorded in the 1800s in a training school for the intellectually disabled (Rosen, 2021). Hans Asperger’s report of boys with a differentiating conceptualization of autism was published in 1944. While Kanner emphasized autism as a developmental condition, Asperger related behaviors resembling personality disorders with fathers of the children he observed showing similar problems (Rosen, 2021).
In the 1970s, the first checklist for assessing autism symptomology was created to be included within the DSM (Diagnostic Statistical Manual of Mental Disorders). Many lines of study influenced this addition to the DSM III which included providing support for the biological origin of Autism (Rosen, 2021).
At the time that autism was first included in the DSM III, autism was reported at a rate of 3-7 in 10,000 children with a marked gender difference noting males were 3-5x more likely to be diagnosed. Within this diagnostic criteria, all criteria must had been met, a lack of developmental orientation was present, and has unclear definition for rationale of childhood onset of Pervasive Developmental Disorders.
In 1987 several changes to impact significant conceptualizations of autism were made in the DSM III-R. This included the name change from ‘infantile autism’ to ‘autistic disorder’ which illustrated the need for a more flexible and developmental-orientated approach (Rosen, 2021).
Our most current edition of the DSM is the DSM-V which was published in 2013. The DSM-IV included the attempts to categorize autism into empirically-defined subcategories including Autistic Disorder, Asperger’s Disorder, Pervasive Developmental Disorder, Rett’s Disorder, and Childhood Disintegrative Disorder. The move to consolidation within the DSM-V was motivated by multiple studies indicating variability in autistic symptoms and experiences (Rosen, 2021). This shift from multiple subcategories to a single dominion improved diagnostic specificity and illustrated adequate diagnostic sensitivity.
Both the DSM-5 and the ICD-11 use autism spectrum disorder as a unitary classification of core symptoms including severity levels based on level of support needed for individual functioning to encompass individual variation (Rosen, 2021).
Current assessment tools continue to evolve while placing a strong emphasis on the importance of interpreting behaviors within particular context such as cultural expectations, and biologically based sex differences (Rosen, 2021). Gender inconsistency continues to be apart of the discussion due to the original diagnostic measures using male-dominated samples.
With all historical data considered, it is a natural progression of increased identification of those identified on the autism spectrum. As a practicing clinician utilizing the most updated and inclusive diagnostic measures, I can vouch for the evolution of these tools and evolving diagnostic criteria. This is a good thing! Continued persistence toward inclusion, introspection, and curiosity is necessary for the continued understanding of the one organ we know very little about. The brain and the professional fields that are put in place to study it have a duty to learn, not a duty to judge.
“HHS wants therefore to encourage clinicians to exercise their best judgment use of acetaminophen in pregnancy by prescribing the lowest effective dose for the shortest necessary duration and only when treatment is required.”- RFK
- This has been long established within the medical field. Tylenol has been approved for use in pregnant women since the 1960s.
Furthering the Stigma
What the latest announcement did was stigmatize Autism further, targeted mothers, identifying Autism as something to prevent vs understand and support, and perpetuate a cycle of blame that is cruel and unfounded by evidence-based scientific research. Autism is not a newly discovered phenomenon, but a Neurotype that has been studied for decades. With the broadening of diagnostic criteria in 1994 and 2013, expansive and empirically-researched studies, better informed screening and assessment tools, and an increase in professionals recognizing Autism, a natural rise is certain.
As Neuro-affirming clinicians we have a duty to protect and work in the best interest of our clients and the populations we have dedicated our life’s work toward.
So, pardon us as we clap back in an empirically-supported way~
Resources
Bai D, Yip BHK, Windham GC, Sourander A, Francis R, Yoffe R, Glasson E, Mahjani B, Suominen A, Leonard H, Gissler M, Buxbaum JD, Wong K, Schendel D, Kodesh A, Breshnahan M, Levine SZ, Parner ET, Hansen SN, Hultman C, Reichenberg A, Sandin S. Association of Genetic and Environmental Factors With Autism in a 5-Country Cohort. JAMA Psychiatry. 2019 Oct 1;76(10):1035-1043. doi: 10.1001/jamapsychiatry.2019.1411. PMID: 31314057; PMCID: PMC6646998.
Grinker, R. R. (2025, September 24). Opinion | Autism Has Never Been One Thing. The New York Times. https://www.nytimes.com/2025/09/24/opinion/autism-rates-science-diagnosis-parent.html
Karimi P, Kamali E, Mousavi SM, Karahmadi M. Environmental factors influencing the risk of autism. J Res Med Sci. 2017 Feb 16;22:27. doi: 10.4103/1735-1995.200272. PMID: 28413424; PMCID: PMC5377970.
Rosen NE, Lord C, Volkmar FR. The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond. J Autism Dev Disord. 2021 Dec;51(12):4253-4270. doi: 10.1007/s10803-021-04904-1. Epub 2021 Feb 24. PMID: 33624215; PMCID: PMC8531066.
