AUTISM THROUGH A NEURODIVERSITY LENS

Emily K. Abel

It is easy to find reasons to oppose Robert F. Kennedy Jr.’s directive to the Centers for Disease Control and Prevention (CDC) to investigate the link between autism and vaccines. Arguments that undoubtedly are familiar to readers include the following:

1. The research is a waste of money. No rigorous study has demonstrated an association between vaccines and autism. The notion of such a link originated in a 1998 article by Andrew Wakefield, a British doctor, in The Lancet. The journal subsequently retracted the article, and the UK’s General Medicine Council stripped Wakefield of his license to practice medicine. Since then, at least a dozen studies have debunked the theory that vaccines cause autism. Mainstream medical journals have rejected the one study Kennedy now cites to support his theory. Wakefield finally arranged its publication in a journal founded by vaccine skeptics.

2. Kennedy chose a vaccine critic—David Geier—to lead his mandated CDC investigation. For many years Geier and his father, Mark Geier, have published papers promoting the discredited theory that vaccines cause autism. In 2011, the Maryland State Board of Physicians disciplined David Geier for practicing medicine without a license. “It seems the goal of the administration is to prove that vaccines cause autism, even though they don’t,” remarked Alison Singer, president of the nonprofit Autism Science Foundation. “They are starting with the conclusion and looking to prove it. That’s not how science is done.”

3. Kennedy’s statistics are flawed. During his confirmation hearings, he stated that autism rates “have gone from 1 in 10,000…and today in our children, it’s one in 34.” Trump popularized those figures. “20 years ago, Autism in children was 1 in 10,000” he wrote on Truth Social. “NOW IT’S 1 in 34. WOW! Something’s really wrong.” Those numbers are “what’s really wrong.” According to data from the CDC, approximately 1 in 36 children have received autism diagnoses today, compared to 1 in 150 in 2000.

4. Broadening the definition of autism helps to explain the rising rate of diagnoses. The latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) eliminated Asperger’s syndrome as a separate category and folded it into autism. Clinicians who previously might have looked for autism symptoms primarily among boys increasingly are aware that girls and adults also can be affected.

5. It is likely that Kennedy’s erroneous statements have increased both autism stigma and vaccine skepticism. “The way RFK Jr. talks about kids on the autism spectrum,” wrote Peter Hotez, a vaccine scientist and the father of an autistic girl, “he treats them like mental defectives, so that will stigmatize both the kids and families with autism.” Although measles is one of the most contagious diseases and can have extremely serious sequelae, Kennedy’s assertions appear to have fueled vaccine hesitancy even as the measles outbreak spreads to more people and more states. Vitamin A, which Kennedy touts instead of vaccines, can be toxic in large doses. Several cases of vitamin A toxicity in children have already appeared.

6. Autism may not be a discrete entity with a single cause. Mary Coleman, a pediatric neurologist, and Christopher Gillberg, a professor of child and adolescent psychiatry, wrote that the “current consensus is that there are many different biological routes to autism, many different aetologies.” The last time Americans attributed autism to a single cause was between 1950 and the late 1970s, when researchers blamed autism diagnoses on “refrigerator mothers.” One of the major popularizers of that theory was Bruno Bettelheim, whose book The Empty Fortress suggested that autistic people are walled off from society and have no inner lives.

But the most compelling reason to protest Kennedy’s reckless directive is that, when viewed from a neurodiversity perspective, autism is not always a tragedy. Soon after Judy Singer, an Australian sociologist, coined the term “neurodiversity” in 1998, it was quickly adopted by the emerging autistic self- advocacy movement.

A central premise of the neurodiversity framework is that many of the problems autistic people encounter stem not only from traits that are intrinsic to autism but also from interacting with environments (in families, schools, healthcare settings, and workplaces) that do not accommodate their needs. A recent study which included autistic people as research partners concluded that the major cause of autistic workers’ burnout is not too much work but rather the need to “mask autistic behaviors through a workday” which results in “chronic exhaustion, reduced ability to tolerate stimuli like light or sound, and the loss of skills.”

Another basic tenet of the neurodiversity model is that autism is not a mental defect or developmental disorder but rather a condition with strengths as well as deficits. Autistic people excel at pattern recognition, creativity, attention to detail, and focus (an especially critical trait as the spread of social media is believed to diminish Americans’ powers of concentration). A 2017 article in the Harvard Business Review Magazine urged companies to hire people with autism and other neurodiversities to gain a “competitive advantage.” “Because neurodiverse people are wired differently from ‘neurotypical’ people,” the authors wrote, “they may bring new perspectives to a company’s efforts to create or recognize value.”

In his widely cited 2015 book, NeuroTribes: The Legacy of Autism and the Future of Neurodiversity, Steve Silberman noted the large percentage of scientists who displayed many characteristics associated with autism in the early days of Silicon Valley. He focused on John McCarthy, a mathematician and engineer who taught the first undergraduate course on computer programming at the Massachusetts Institute of Technology in the 1950s and subsequently established the Stanford Artificial Intelligence Laboratory in the early 1980s. McCarthy exhibited some classic traits of autism, including brusqueness, physical clumsiness, and rudeness. He also had many of autism’s positive features including “the ability to solve problems from angles that his more socially oriented colleagues missed.” Silberman concluded that McCarthy was very fortunate to find a place in a field “that was perfectly suited to his strengths while being tolerant—indeed, appreciative—of his many eccentricities.”

Holden Thorp, the editor-in-chief of the academic journal Science and a professor of chemistry and medicine at George Washington University, wrote in the New York Times, “Far from being solely a deficit, I believe my neurodiversity has made me a better scientist because my autistic thinking leads me to search for patterns, a crucial skill in science.” And the biologist Temple Grandin credits her autism for her intuitive recognition of animals’ feelings which has served her well throughout her career. Although she did not speak until she was three and a half, and doctors initially diagnosed her with brain damage, Grandin earned a Ph.D. and has been an esteemed professor of animal science at Colorado State University for four decades.

Medical historians warn about the dangers of diagnosing historical figures through the lens of disease classifications developed more recently. Nevertheless, various commentators have speculated that some of the people who made extraordinary contributions in the past would be diagnosed as autistic if they were alive today. The list includes Albert Einstein, Isaac Newton, Ludwig Wittgenstein, and Emily Dickinson, to name just a few.

In sharp contrast to the neurodiversity movement, many parents of children with more serious intellectual and behavioral challenges protest that the neurodiversity model applies to only a select group of autistic people. Parents asked in 2023 what they wanted other people to understand about raising an autistic child responded, “Stop asking me what his ‘gift’ is. Autistic people aren’t all like Dustin Hoffman in Rain Man with being able to count all the toothpicks in the box instantaneously”; “My child was diagnosed with autism—not as a savant or genius”; “I feel like a horrible parent not being able to identify the gift/talent of my autistic son.”

Although neurodiversity proponents respond that they are seeking more dignity, respect, and inclusivity for all autistic people, many parents are not convinced that the framework addresses their families’ needs. What unites members of both groups is opposition to more research investigating the long debunked association of autism with vaccines and a call for more attention to providing the supports and services that everyone with autism needs but finds difficult to obtain.

Emily K. Abel is professor emerita at the UCLA-Fielding School of Public Health. Her most recent book is Gluten Free for Life: Celiac, Medical Recognition, and the Food Industry (New York University Press, 2025).

Sources:

Holden Thorp, “I Was Diagnosed with Autism at 53. I Know Why Rates are Rising,” New York Times, March 20, 2025.

Steve Silberman, NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (New York: Avery, 2015.

Robert D. Austin and Gary P. Pisano, “Neurodiversity as a Competitive Advantage,” Harvard Business Review Magazine, May-June2017.

Avery Lotz, “Trump Spreads Autism Misinformation in RFK Jr. Confirmation Push,” Axios, February 4, 2025.

Lena H. Sun and Fenit Nirappil, “Vaccine Skeptic Hired to Head Federal Study of Immunizations and Autism,” Washington Post, March 25, 2025.

Jessica McDonald, “RFK Jr. Cites Flawed Paper Claiming Link between Vaccines and Autism in HHS Confirmation,” January 31, 2025, www.factcheck.org.

Emily Willingham, “’Autistic Voices Should be Heard.’ Autistic Adults Join Research Teams to Shift Focus of Studies,” Science, April 29, 2020.

Kathy Leadbitter, et al., “Autistic Self-Advocacy and the Neurodiversity Movement,” Frontiers in Psychology, April 2021.

Francesca Happé and Uta Frith, “Annual Research Review: Looking Back to Look Forward—Changes in the Concept of Autism and Implications for Future Research,” Journal of Child Psychology and Psychiatry, 61, no. 3 (2020): 218-232.

Elizabeth Pellicano and Jacqueline den Houting, “Annual Research Review: Shifting from’Normal Science’ to Neurodiversity in Autism Science,” The Journal of Child Psychology and Psychiatry, 63, no. 4 (2022): 381-396.