Podcast Summary: Short Wave – "Tylenol and Autism: What’s True and What Isn’t"

Date: September 24, 2025
Host: Sydney Lupkin (NPR)
Guest: Dr. Helen Tager Flusberg (Professor Emerita, Boston University; Founder, Coalition of Autism Scientists)
Duration: ~16 minutes

Episode Overview

This episode of "Short Wave" critically examines a recent government announcement linking acetaminophen (Tylenol) use during pregnancy to increased autism risk. Host Sydney Lupkin interviews Dr. Helen Tager Flusberg—an accomplished autism researcher—to unpack what’s actually known (and not known) about the science behind these claims. The conversation also dives into the complexities of autism diagnosis trends, the evidence (or lack thereof) for Tylenol and autism, and the administration’s comments about autism and new “treatments.”

Key Discussion Points and Insights

1. The FDA Announcement and Political Context

[00:28 - 01:32]

• The U.S. president, joined by Health Secretary Robert F. Kennedy, Jr. and Dr. Mehmet Oz, claimed that acetaminophen used in pregnancy raises autism risk and called for drug label changes.
• The same announcement recommended Leucovorin (folinic acid, a form of vitamin B) as an autism treatment, though it's not FDA-approved for such use.
• Dr. Tager Flusberg and much of the scientific community were blindsided by what they saw as “extremist” and unsupported claims.
  • Quote: “This has been the most devastating week of my career. I had no idea how extremist the perspective would be.”
    (Helen Tager Flusberg, 01:32)

2. Autism Rates: What’s Really Going On?

[04:00 - 05:31]

• Autism prevalence in the US has shifted from 1 in 150 children (25 years ago) to 1 in 31 (most recent CDC data).
• Dr. Tager Flusberg attributes this increase to:
  • Greater public and clinical awareness of autism.
  • Expanded diagnostic criteria and services.
  • The allowance of double diagnoses (e.g., ADHD and autism), which wasn’t permitted until about a decade ago.
    • Quote: “Even up until 10 years ago, if you had ADHD, you would not be allowed...to have a second diagnosis of autism... We know that in children, up to half of them may not only have autism, but also meet diagnostic criteria for ADHD.”
      (Helen Tager Flusberg, 04:22)

3. The Science Linking Acetaminophen (Tylenol) and Autism

[05:31 - 08:57]

• Over 40 observational studies have found a small statistical association between prenatal acetaminophen use and autism. However:
  • Observational studies can’t establish causality.
  • Many confounding factors exist: Maternal health, genetics, and other underlying conditions may affect both acetaminophen use and autism risk.
  • The data are “noisy”: Reliance on maternal recall about OTC medication is imprecise.
    • Quote: “...there’s a small association. But we cannot, from these kinds of observational data, make any claims about causality.”
      (Helen Tager Flusberg, 06:35)
    • Quote: “The data we have on the actual use of acetaminophen is what I call noisy data. Okay. It's not the highest quality.”
      (Helen Tager Flusberg, 08:13)

4. Leucovorin (Folinic Acid) as an Autism Treatment?

[08:57 - 12:29]

• Leucovorin, a form of folinic acid (B vitamin), is under discussion as a potential autism treatment.
  • It’s FDA-approved for offsetting chemotherapy toxicity, not autism.
  • Evidence supporting its effectiveness for autism is limited to a few small-scale, preliminary studies.
  • No clear data on which symptoms might improve or appropriate dosing.
  • The rush to promote it for autism jumped normal regulatory steps and was met with skepticism by autism scientists.
    • Quote: “Picking out Lucavorin was an easy target. I’ve been in this field for decades now, Sydney. We have seen this story play out so many times...”
      (Helen Tager Flusberg, 11:28)
• There are real risks in self-prescribing supplements with no guidelines:
  • Quote: “...since there’s no guidelines at all on dosage for Leucovorin. If I was a mom and buying this tomorrow, I’d have no idea how much to give. I’d be relying on guidance from some other mom to tell me.”
    (Helen Tager Flusberg, 12:03)

5. Tylenol Use in Pregnancy: Dangers of Overcorrection

[12:29 - 13:31]

• The administration claimed there are “no downsides” to avoiding Tylenol. Dr. Tager Flusberg strongly disagrees:
  • Pregnant women need to treat conditions like fever and infection; untreated fever during pregnancy is itself a known risk factor for autism and other complications—far higher risk than that posed by Tylenol.
  • Avoiding Tylenol may lead people to seek even less safe alternatives.
    • Quote: “If you're a pregnant woman and...you are running a fever...the downside of not taking Tylenol is...you are prolonging the time... you are running a fever. Infection during pregnancy and stress...increase the risk for autism well above the level of risk that’s posed by Tylenol.”
      (Helen Tager Flusberg, 12:40)

6. The Administration’s Framing of Autism

[13:31 - 15:31]

• The administration described autism in a way Dr. Tager Flusberg calls “appalling” and “callous,” failing to recognize the diversity of autism or the humanity and love within autistic families.
  • “Profound autism,” representing about 25% of the autistic population, often involves greater challenges, but that’s not the whole picture.
  • The rhetoric ignored autistic people who function at very different levels and misrepresented the disorder.
    • Quote: “They simply don’t see these people with disabilities as having any humanity, as being loved by their family. But importantly, profound autism represents a quarter of the population and the rest...are functioning at very different levels. And he was not speaking about them at all.”
      (Helen Tager Flusberg, 14:33)

Notable Quotes & Memorable Moments

• “This has been the most devastating week of my career.”
  (Helen Tager Flusberg, 01:32)
• “You can’t take a simple one-to-one relationship and make any kind of causal connection.”
  (Helen Tager Flusberg, 07:40)
• “The data we have on the actual use of acetaminophen is what I call noisy data. Okay. It’s not the highest quality.”
  (Helen Tager Flusberg, 08:13)
• “We have seen this story play out so many times...small scale study, promising findings...then the randomized controlled trials...there’s no, there there’s.”
  (Helen Tager Flusberg, 11:38)
• “Profound autism represents a quarter of the population and the rest...are functioning at very different levels...It’s very painful to see autism so misrepresented.”
  (Helen Tager Flusberg, 14:33)

Timestamps for Key Segments

• [00:28 – 01:32]: Recap of government announcement
• [04:00 – 05:31]: Changes in autism rates and contributing factors
• [05:31 – 08:57]: Detailed look at the Tylenol-autism research landscape
• [08:57 – 12:29]: Discussion on Leucovorin (folinic acid) as an autism treatment
• [12:29 – 13:31]: Risks of avoiding Tylenol during pregnancy
• [13:31 – 15:31]: Critique of administration rhetoric about autism

Conclusion

This episode powerfully rebuts oversimplified claims about Tylenol and autism, emphasizing the limits of current research and the importance of perspective in autism discourse. Dr. Tager Flusberg warns against both unsupported medical guidance and stigmatizing language, reinforcing calls for evidence-based policy and compassion for autistic people and their families.

(For full context and expert nuance, listeners are encouraged to hear Dr. Tager Flusberg's insights in the episode.)