The Administration’s Autism Plan Is Controversial – But It Also Presents a Vital Opportunity

Recent conversations around autism have been intense, with renewed public discourse, strong reactions to Robert F. Kennedy Jr.’s proposed initiatives and the latest statistics on rising autism prevalence. Yet amid all the noise, the most critical challenge families face in the autism journey is being overlooked. Let me explain: imagine being diagnosed with a serious medical condition — say, type 2 diabetes — based solely on a questionnaire your doctor filled out, without any lab tests or biological markers. Would you accept it? That is, essentially, how we diagnose autism spectrum disorder today.

Autism is a neurodevelopmental condition defined entirely by observable behaviors — difficulties with social interaction, language delays, and repetitive movements, among others. In other words, you’re considered autistic because you behave a certain way. Where’s the biology in this definition? This isn’t to dismiss the importance of behavioral assessment — it’s critical — but it should not be the only tool guiding autism diagnosis and care.

For years, we were limited in our ability to define the biology of autism. That is not the case anymore.

Interplay of multiple systems

According to the CDC, “There is not just one cause of ASD. Many different factors have been identified that may make a child more likely to have ASD, including environmental, biologic, and genetic factors.” That’s the scientific consensus — and it mirrors what we know about many complex conditions: causation is rarely singular, but instead rooted in the interplay of multiple systems. For years, we pinned our hopes on genomics. But despite the promise, no single “autism gene” has emerged. Genetics alone cannot explain the rising prevalence of autism diagnoses — our genes simply don’t change that quickly. 

So what else can we measure objectively? The answer lies in the non-genomic side of the equation: our biology, our metabolism, and how our bodies respond to environmental exposures. Today, we finally have the tools to track these dynamic systems over time, revealing measurable patterns and biological signatures that help decode autism at the molecular level. Just as blood sugar provides an objective measure for diabetes diagnosis, we now have the means to define the biological pathways of autism.

No family should wait over a year for answers

Families today often endure long, exhausting journeys to get a diagnosis, many times waiting over a year. The benefits of early identification and intervention are well-documented, yet autism is still diagnosed far too late.

Despite this, when it comes to autism and many other neurodevelopmental conditions like attention deficit hyperactivity disorder (ADHD), biochemical testing plays little to no role in the diagnostic process. At best, it’s an afterthought. That has always perplexed me. Autism is estimated to be 50% to over 80% heritable, meaning many risk factors are present from conception — long before behavioral symptoms emerge. And yet, we continue to rely solely on observable behaviors, which limits our ability to detect autism in the earliest, most formative years of brain development.

This is one reason the median age of autism diagnosis in the U.S. remains around 4 years old, while waitlists for diagnostic evaluations grow longer by the day. There is a better way. In my view, the future of autism care must begin at birth — by screening every newborn for biological markers of risk.

 A call for a less polarized discussion

Unfortunately, like so many debates in today’s public sphere, the conversation around the administration’s autism-related proposals has quickly become polarized, and in that polarization, meaningful opportunities are being lost. One recent flashpoint is the use of the word “epidemic” to describe autism, which has been criticized by many experts. But dismissing the word shouldn’t mean dismissing reality. The rising number of autism diagnoses has placed real and growing strain on families, school systems, and healthcare providers, and that burden deserves serious attention. We can and must focus on the most important truths: the impact of the increasing prevalence of autism is real, and it needs to be addressed.

Rather than letting rhetoric derail progress, we should seize this moment to move conversations and actions forward. The administration’s focus on environmental contributors to autism carries immense potential. Policy shifts toward healthier food, cleaner air and water, and reduced toxic exposure will bring broad public health benefits to overall health. The medical and scientific community should wholeheartedly welcome this momentum and match it with innovation.

New technologies now allow us to measure biological markers of neurodevelopmental conditions with precision and objectivity. These innovations won’t replace clinicians’ expertise or behavioral assessments — they will complement and strengthen them. Behavior matters. Biology does too.

Let’s not miss this moment. Let’s meet it — with clarity, with science, and with the resolve to build a better path forward for autistic individuals and their families.

Photo: MariaDubova, Getty Images

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