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Audio long read: Autism is on the rise — what’s really behind the increase?

·26 min·2 clips

US Health Secretary Robert Kennedy Jr. calls rising autism an 'epidemic' caused by environmental toxins, sparking scientific backlash.

Helen Pearson's Long Read article, read by Benjamin Thompson, opens with RFK Jr.'s April press conference presenting autism prevalence data: 1 in 31 8-year-olds diagnosed in 2022, up from 1 in 158 in 2000. Kennedy called it an epidemic caused by an unnamed environmental toxin and announced a study to find the responsible agent. The NIH's Autism Data Science Initiative then offered $50 million for research on autism causes. Researchers were not pleased. The scientific consensus, Pearson presents, is that the rise in prevalence is predominantly explained by changes in how autism is diagnosed and recognized: the DSM criteria have expanded, the diagnostic category broadened to include a wider spectrum of presentations, clinical awareness among practitioners has improved, and historically underdiagnosed groups including women and older adults are now being identified. Swedish researcher Sven Bulte is quoted: we see an epidemic of diagnoses, not an epidemic of autism. Population genetics studies have consistently found high heritability for autism. Environmental factors encountered during pregnancy have been linked to increased risk in some studies but their precise roles remain complex and hard to isolate. The article examines concerns that Kennedy, a known anti-vaccine advocate, may use the ADSI to fund research that promotes the long-debunked vaccine-autism hypothesis. Researchers are also concerned that the framing of an epidemic requiring a responsible agent will crowd out the evidence-based work on complex genetic and developmental mechanisms. The article also discusses autistic people's range of traits and the importance of including autistic voices in research design and priorities.

As heard by us

A measured tour through the numbers behind rising autism diagnoses.

Nature's Long Read follows the rise in autism diagnoses and the dispute over what the numbers mean, moving from the HHS Secretary's April press conference to the research methods used to count autism.

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Why you'd press play

You want the autism numbers without the press-conference fog machine, and with the methods behind the counts.

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