Tangle Podcast – SPECIAL EDITION: Interview with Jill Escher, Head of the Escher Fund for Autism

Host: Ari Weitzman (Managing Editor, Tangle)
Guest: Jill Escher
Date: September 24, 2025

Episode Overview

This special edition episode of the Tangle podcast features an in-depth interview with Jill Escher, a leading philanthropist and advocate in autism research, and head of the Escher Fund for Autism. The conversation centers on recent developments in autism research — specifically, a controversial announcement from the U.S. Department of Health and Human Services (HHS) and FDA about a potential link between acetaminophen (Tylenol) use during pregnancy and increased risk of autism and ADHD in offspring. Escher provides her critical insights on the evidence (or lack thereof) behind these claims, the real causes of rising autism prevalence, and widespread misconceptions in media and scientific discourse.

Key Discussion Points & Insights

1. The FDA Press Release on Acetaminophen and Autism

[03:35–06:51]

• Headline: The U.S. FDA announced label changes for acetaminophen, citing research that suggests use during pregnancy may elevate the risk of neurological conditions like autism and ADHD in children.
• Escher’s Response:
  • Skepticism about Scientific Foundation: Escher believes the decision is "not founded in science" and criticizes the administration's public pronouncement as "irresponsible... based only on... cherry picking some research and not on fully vetted science" ([04:24], Escher).
  • Epidemiological Evidence: Acetaminophen has been extensively studied; most large, robust epidemiological studies find little to no association with autism. Where associations are found, they’re typically "quite small."
  • Lack of Temporal and Biological Plausibility:
    • No Correlation with Rising Autism Rates: "There hasn't been this rapid increase in the use of prenatal acetaminophen in the recent decades where we see the upswing of autism. So there’s no real temporal association at all" ([05:24], Escher).
    • Mechanistic Disconnect: "The underlying mechanisms of autism don’t map to what we might see with acetaminophen use... I just think that they were very eager to get something on the map. They just, I feel the administration just wanted to throw some spaghetti at the wall at this point." ([06:31], Escher).

2. The True Nature of Rising Autism Rates

[06:51–09:14]

• Host's Query: The media often suggest the increase in autism diagnoses is due to expanded diagnostic criteria, not a real rise in incidence. Is this accurate?
• Escher’s Strong Rebuttal:
  • Sharp Increase is Real: "I strongly disagree with those who attribute the rapidly and very markedly dramatically increasing rates of autism to awareness and diagnostic practices. There actually is next to no hard evidence for that at all. This is purely based on speculation." ([09:14], Escher)
  • California Data Example:
    • "There were about 3,000 such cases in the 1980s and today there are more than 220,000 such cases. Right. This is again, we're comparing apples to apples here... So yeah, 3,000 to 220,000. It's not even close." ([10:28], Escher)
    • This data, focusing on severe, impairing autism as recognized by California’s developmental services system, counters the narrative that diagnostics alone account for the rise.
  • No Evidence Diagnostic Shifts Explain the Increase:
    • "Never been any showing that that is attributable to diagnostic shifts... when it has been studied... the growth cannot be explained by diagnostic factors." ([11:12], Escher)
  • Broader International Patterns: Similar dramatic increases visible in other developed nations.

3. Why the Uncertainty about Autism’s Rise Persists

[11:50–12:11]

• Uncomfortable Truths:
  • "We frankly just don't understand what's causing the increase. And I think that it's the discomfort with the lack of understanding that leads us to kind of be in denial about it and has us looking for justifications for it that aren't really there." ([11:55], Escher)

4. Is it Appropriate for the Administration to Investigate Environmental Risks?

[12:11–13:13]

• Host’s Question: Given the real increase, is it appropriate for the administration to be investigating possible environmental contributors, even if the acetaminophen finding is weak?
• Escher’s Balanced Agreement:
  • "Yeah, well, this is one area where I fully agree with the administration..." ([13:13], Escher)
  • (Note: The interview clip ends abruptly due to sample preview, but the direction indicates measured support for investigating environmental factors, as long as the science is strong.)

Notable Quotes & Memorable Moments

• “I think it was not founded in science, and I think that it was irresponsible, frankly, of the administration to hold a press conference… to make this sort of pronouncement, which was based only on, I think, cherry picking some research and not on fully vetted science that incorporated more thorough research on the matter.”
  — Jill Escher, [04:24]

• "Acetaminophen has been around since the 50s, I believe ... there hasn’t been this rapid increase in the use of prenatal acetaminophen in the recent decades where we see the upswing of autism. So there’s no real temporal association at all."
  — Jill Escher, [05:24]

• "I strongly disagree with those who attribute the rapidly and very markedly dramatically increasing rates of autism to awareness and diagnostic practices. There actually is next to no hard evidence for that at all. This is purely based on speculation."
  — Jill Escher, [09:14]

• "There were about 3,000 such cases in the 1980s and today there are more than 220,000 such cases. Right... So yeah, 3,000 to 220,000. It's not even close."
  — Jill Escher, [10:28]

• "We frankly just don't understand what's causing the increase. And I think that it's the discomfort with the lack of understanding it that leads us to kind of be in denial about it and kind of has us looking for justifications for it that aren't really there."
  — Jill Escher, [11:55]

Timestamps for Key Segments

• [03:35] — Ari introduces the HHS/FDA acetaminophen announcement and asks for Jill Escher’s response.
• [04:24] — Escher begins critique of the FDA’s position and gives overview of research.
• [06:51] — Discussion shifts to the increase in autism rates and diagnostic expansion.
• [09:14] — Escher provides a detailed rebuttal using California’s autism data.
• [11:50] — Escher reflects on the broader difficulty of facing unknown causes for autism’s rise.
• [12:11] — Positive note: Escher agrees it’s good for the government to pursue cause investigation, with scientific rigor.

Summary and Takeaways

• Escher argues the FDA’s warning about acetaminophen and autism is not backed by strong scientific evidence, and worries it will create unnecessary anxiety among pregnant women without corresponding benefit.
• Diagnostic expansion and increased awareness cannot fully explain the "real and dramatic" rise in autism—especially severe cases—over recent decades. This increase is measurable, stark (as in California data), and mirrored internationally.
• The scientific community hasn’t yet explained what drives this rise; denial or over-attribution to shifting diagnostics is rooted in societal discomfort with uncertainty.
• Escher welcomes robust, careful scientific investigation into potential environmental or medical contributors to autism, as long as findings are evidence-based and not based on selective research.

For listeners:
This conversation offers a nuanced, data-driven challenge to prevailing public narratives about autism, with Jill Escher urging policymakers and the media to avoid oversimplified explanations and to focus on genuine scientific inquiry.