Danielle Kurtzleben (2:16)

So, Yuki, how does what Trump's saying here compare with the science?

Yuki Noguchi (2:20)

You know, there's no scientific basis for him saying that, you know, mothers ought not take Tylenol. In fact, it's one of the few medications that pregnant women are told to take. A number of studies have been done on this topic of acetaminophen's relationship with autism, the largest of which was funded by the NIH and Sweden and found no additional risk. You know, Some studies have looked at the possible correlation between using Tylenol and autism, and there may be a correlation, but that's not the same thing as finding a cause. You know, remember, Tylenol is, again, a very common medication and one that pregnant women are told is safe to take for high fever and pain. So to say that Tylenol caused it is kind of like saying, I drank coffee this morning and now I feel sick. I mean, it doesn't mean that the coffee caused the illness. Right. The two things could be an unrelated correlation. And what research shows is that, you know, autism's primary cause is actually genetic and that perhaps hundreds of genes may be involved in its development.

Danielle Kurtzleben (3:29)

Well, there's something else Trump said during that event. He also warned against using Tylenol for infants. But I gotta say, I know when I was pregnant, when I had an infant, I was warned, you do not want to let your own fever or your baby's fever get too high. And meanwhile, Trump is making Tylenol sound scary. So I'm wondering, what are the risks for both pregnant women and infants if they don't take Tylenol when they have a fever?

Yuki Noguchi (3:54)

Untreated fever during pregnancy can actually lead to neural defects, damage to the fetus's heart, you know, preterm birth or even miscarriage. So toughing it out is really not what doctors would advise. And for babies to, you know, high fever, I mean, fever is common among babies, but it can be an indicator of, you know, a broader problem. An infection, for example.

Danielle Kurtzleben (4:16)

Well, Yuki, something else happened at this event. The president not only said Tylenol causes autism, but he also offered up a different medication as a treatment for it. Can you tell us what he said?

Yuki Noguchi (4:25)

Yeah. The president's deputies suggested that an old drug called leucovorin is showing promise as a treatment for autism and even referred to it as a reversal drug. But that's very, very premature to say. So there's not that sort of indicates that it would actually reverse autism at all. What leucovorin is, is a form of vitamin B that's most often used during chemotherapy, you know, because it's able to basically bypass the normal pathways to get vitamin B to the brain in people who have a deficiency of vitamin B. Now, very few studies have been done on its effects on autism. There is a study that shows it may alleviate symptoms for those with both autism and this vitamin B deficiency. You know, but the percentage of people who have both is still in the minority. And again, that's not very well researched. You know, in general, What I would say is in endorsing leucovorin, I mean, the administration is basically rewriting how the health system works. I mean, including with medicines that have been historically vetted and checked for safety, you know, based on very extensive scientific research. The Food and Drug Administration usually takes years to review these things before allowing them to go to the market. But this administration this week said it will basically change the labeling on leucovorin to broaden its use to those who have this vitamin B deficiency and autism. And, you know, it's planning to track the effects of that. I mean, and basically, what is going to be a real world experiment with this drug.

Danielle Kurtzleben (6:00)

Now, Domenico, all of this is pretty unusual for a president to make this type of an announcement on a health issue. Politically, why is Trump doing this?

Domenico Montanaro (6:08)

Yeah, there's a lot of politics at play here, but once RFK Jr dropped out of running for president and then endorsed Donald Trump during the presidential campaign, you sort of knew that there was gonna be this marriage between RFK's political base that then now was being brought into the fold for Donald Trump to try to win a second term. And you knew that RFK Junior's principal thing he'd gotten so much attention for was about autism and vaccines and talking about that as a health issue. And we know that once he picked RFK Jr as his health and Human Services Cabinet secretary, that they said that they would find a solution by September, and here we are. And I think that there's a political risk in this, obviously, as well, because you have a lot of people who now are not really believing what comes out of the government, not believing what comes from Donald Trump or from RFK Jr and you're blaming women. There's a lot of women who feel like this is targeting them to say, oh, tough it out. This is something to do with you, because you gave yourself Tylenol to make yourself feel better. Now you're giving your kid autism. You know, that's given how much has been done by Donald Trump in what a lot of women see as targeting them on reproductive rights. This is just one more tab of that that's going to keep women engaged, especially a year before the midterms.

Danielle Kurtzleben (7:28)

That's a very good point. And I do want to go back to what you were saying about people not trusting Donald Trump, Trump in particular. Long history of casting distrust on authority, on science, on expertise. It feels like this is part of that through line.

Domenico Montanaro (7:41)

Right? I mean, that's been Donald Trump's message. Trust me. Don't trust the experts. The experts don't know what they're talking about. We saw that by Vice President J.D. vance during the debate last year where he's talking about, oh, you know, expert schmexperts, basically. You know, you don't need to trust them. They've been wrong about everything. And we're not talking about just healthcare, you know, and I think a lot of this has roots in Covid, but we're talking about the economy, immigration, crime, whatever it is. That's what this administration is really about. This is at the heart of Trumpism, of MAGA ism, to say you trust one man, Donald Trump, and all of the people that he says are the real experts, even if those people don't have the credentials or the scientific community says that these things are not necessarily the way that they should be presented.

Danielle Kurtzleben (8:27)

Okay. Well, we need to take a quick break, but we will have more in a moment.

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Danielle Kurtzleben (9:50)

And we are back. We've been talking about recent health recommendations that President Trump has made. And these announcements that he's made seem to be part of a narrative that autism is a problem in need of a solution. What is going on here? Domenico, let me start with you.

Domenico Montanaro (10:05)

Well, I mean, this was something, you know, that Trump had talked about during the campaign. And he said even back to 2015 when he was running, that he believes that vaccines had something to do with autism because we've seen an increased percentage of people who are diagnosed with autism. That doesn't mean that there are more people with autism or that the Amish don't have autism or that Cubans don't have autism, as Trump has claimed. As Trump claimed this week in that same press conference. This has to do mostly people believe with medical diagnoses and being better about that. I mean, 30 years ago, this wasn't something that was as prevalent that doctors were looking for, that had the same signs of. Plus, it's a spectrum disorder, right? I mean, autism is a disorder with a wide range. I mean, you have varying abilities, people who show fewer symptoms to people who are non verbal. So it's not exactly like one size fits all. But politically, this is something that RFK Jr. Has made a huge part of his political rise as well as his activism before going into politics. And it's something that, given what we saw with COVID and the distrust of the cdc, increasingly the Centers for Disease Control and Prevention from the right, then that's something that Donald Trump has been able to latch onto politically and sort of ride that wave a little bit. And this is a big piece of that.

Danielle Kurtzleben (11:27)

Well, Yuki, I'm very curious how families, especially families with children with autism spectrum disorder, how have they received Trump's remarks?

Yuki Noguchi (11:36)

You know, anyone who understands autism knows that it's a complex disease with complex contributing factors and likely complex solutions. Right. And the president's remarks really don't reflect that. You know, he's kind of looking for a simple cause and a simple solution. But in terms of how families are reacting, I mean, for sure, some families are excited, excited about leucovorin, and some have wanted to see if that might work on their particular child. But, you know, the idea, again, that there's an easy solution strikes most families as pretty bogus. You know, I've talked to families who say, you know, there's a lot of supplements and vitamins and solutions that they've been pushed for many years, you know, some of which could even exacerbate their child's symptoms. And, you know, people who know autism know that, like Domenico said, I mean, it is a spectrum. There are so many different manifestations of autism. And so therefore, what really seems to work for most families is actually therapies. You know, not a pill, but something like a speech therapy, therapy to help them move better or even eat, because so many autistic people have sensory difficulties. So, you know, I think there is no simple solution. And I talked to a mother named Katie Donovan. She lives in Mahopec, New York, and has a daughter who was diagnosed at 17 months with autism.

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You go through this self blame and you beat yourself up and you ask yourself a million questions. And I've been in therapy for many years and worked on this a lot to come to the conclusion that it isn't something I did. This is just who my daughter is, and she's perfect the way she is, and this is not my fault.

Yuki Noguchi (13:16)

And so Donovan was really dismayed to hear the President's remarks because it reflected a lack of understanding of what autism is. And she felt blamed for her child's condition.

Danielle Kurtzleben (13:27)

And it sounds like also she feels like it pathologizes her child. As she said, my daughter is perfect the way she is. It seems like she was reacting to the idea that. That there's a big problem with her daughter.

Yuki Noguchi (13:39)

Exactly. I mean, that's something that I actually hear from a lot of people in the autism community, is like, these are people who are differently abled and they don't necessarily see themselves as, you know, a problem in need of fixing.

Domenico Montanaro (13:50)

But there are so many parents, right, who have been frustrated and are frustrated with what they see as this increase. They don't know what caused it. They're for solutions. They're looking for answers. And sometimes they grasp at things that are really things that are pushed by charlatans. I mean, a lot of these supplements and injections and all this stuff that really has no basis in science but has basis in commercial sales, essentially. And, you know, you've got vulnerable people who are looking for something to latch onto.

Yuki Noguchi (14:20)

And it's easier to talk about medicine sometimes than the therapies and the supports that they need. A lot of families, you know, will say what they really need is, you know, better access to these therap, the speech therapy, the movement therapy, and for better insurance coverage to cover those things. And what you're actually seeing is the federal government is actually limiting Medicaid coverage, for example, which would affect a lot of these families.

Danielle Kurtzleben (14:43)

You know, Domenico, I think quite a few people watched this event and it reminded them of some of Trump's press conferences during COVID And I'm wondering how what we heard from the White House this week on Tylenol autism, vaccines, how does that fit into a broader pattern from Trump?

Domenico Montanaro (15:00)

Certainly took me back to that time, and there were a lot of parallels with that because it's health information that's being put out, sometimes just throwing stuff at the wall, it seems. I mean, Trump was looking for a magic bullet that would say, in 15 days it'll magically go away. You know, this is very similar to that. And, you know, autism is not something that's just gonna go away by moms not using Tylenol during pregnancy or then using this drug afterward that's designed for a certain sect of kids. It's much more complicated. There are a lot more treatments that are helpful, needed, necessary that parents use and are looking at that aren't medical necessarily. But there's a lot that does need to be researched when it comes to autism scientifically. And this just sort of seems to, you know, go along with what we saw during COVID where people then just don't trust what they're hearing from the federal government and are left on their own looking for answers.

Yuki Noguchi (15:58)

And I will say the president even said by his own admission that he's not very precise at this press conference and that, you know, he believes certain tenets. And so on the basis of that is making these kinds of statements. And I think a lot of scientists have, you know, a lot of concern about that when it comes to, you know, making health policy or health decisions based on someone's belief or supposition. All right.

Danielle Kurtzleben (16:24)

Well, we are going to have to leave it there. Thank you so much for being here, Yuki.

Yuki Noguchi (16:27)

Thank you.

Danielle Kurtzleben (16:28)

I am Danielle Kurtzleben. I cover the White House.

Domenico Montanaro (16:30)

And I'm Domenico Montanaro, senior political editor and correspondent.

Danielle Kurtzleben (16:33)

And thank you for listening to the NPR Politics podcast.

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