Autism, Authority & the Danger of False Certainty

When confident voices demand belief, careful thinking is needed most.

Recently, an older friend of mine sent me a video of RFK Jr. (a press conference where he spoke about autism) [Ref]. My friend said she found it educational and clarifying, but also wanted to know what I thought of it. After replying to her, I thought I would share my views here too, in a little more depth.

But in this post, rather than looking into the genetic/biological explanations or describing the diagnostic process of autism, I'll be focusing on the narrative and rationale behind RFK's discourse.

The Realities We Build with Language

Language is more than a means to convey messages to others or to describe the world. Language is a tool that constructs realities. This is a well-known phenomenon in psychology, particularly among psychologists who work with discourse analysis¹.

So when RFK Jr. uses terms like "epidemic" and "toxin," he is not simply offering a neutral description of autism in the present day. He is constructing a particular version of reality where autism is framed as a tragedy, a danger, something that must be eradicated.

Frustratingly, this fear-based language goes on to shape how people think about autism, how autistic individuals and their families are seen and treated, and how society designs its support systems. It even influences how research priorities are set, something made clear in RFK Jr.'s speech.

However, rather than a disease, or an error that needs to be corrected, autism is a neurodevelopmental difference [1]. Simply put, it is one way, among many, that human minds can be organised.

Also, in his speech, how autism is talked about is only part of the picture, because the way prevalence rates across different periods are compared also shapes his narrative.

This is where we step into the rationale behind RFK Jr.'s speech.

Misleading Historical Comparison

One of the things that impressed my good friend was, as she put it, "all the statistics across the decades" that RFK Jr. brings up. He did mention the word stats, and this is what seems to form the entire premise of his "epidemic" claims, as he points to the lower rates of autism prevalence decades ago compared to the alleged continuously increasing rates we’ve begun to see in recent years.

However, there is important context missing from his narrative. Diagnostic criteria broadened, especially with the publication of the DSM-IV and the DSM-5² [2,3]. These changes meant that many individuals who would not have been identified under older definitions now met the criteria.

There are additional factors that have played a role in the increased rates too.

For example, awareness has increased, with clinicians, teachers, and parents becoming more familiar with the signs of autism, especially in children who were not (stereotypically) male or nonverbal. Further, access has improved, with more children being assessed earlier, more services being offered in schools, and more adults seeking diagnoses. Further still, under-recognised groups have been included, such as minorities and individuals with co-occurring ADHD, for example.

When Context is Dismissed as Myth

So, the rise in autism diagnoses reflects how we now identify and define autism (not a sudden environmental outbreak!). To suggest otherwise not only ignores this historical development, but subtly reinforces the idea that autism is a recent, unnatural phenomenon, something alien or wrong.

Yet RFK Jr. emphasises that focusing on changes in diagnostic practices, increased awareness, and broader definitions amounts to subscribing to mythology and ideology. He goes on to suggest that focusing on these well-documented developments makes someone an "autism epidemic denier."

This is a deeply misleading framing. Understanding historical context is not ideology! It’s careful attention to how knowledge evolves. It is precisely how scientific thinking works, by gathering evidence, recognising social and diagnostic shifts, and resisting the urge to draw simplistic conclusions.

To reduce all of this to mere mythology is to close the door on genuine understanding.

Setting Conclusions Before Evidence

But what strikes me most is how conclusions are drawn. During the speech, RFK Jr. states that environmental toxins must be responsible for the rise in autism, saying, "… this is coming from an environmental toxin," even though no clear evidence has been presented to support this claim. In doing so, he sets the conclusion first and only afterwards searches for evidence to fit it.

This is not how sound scientific reasoning works.

In science, we begin with observations, then form hypotheses that are tested through rigorous investigation. It is the evidence that shapes the conclusions, not the conclusions that dictate what the evidence must be. When this process is reversed, it becomes easy to fall into the trap of confirmation bias, seeing only what supports a pre-existing belief and disregarding everything else.

Serious research into autism has followed a different path. Decades of studies have built a solid foundation showing that autism has a strong genetic basis [1]. While research continues into how genetic and environmental factors may interact in complex ways, the idea that a toxin(s) is behind autism ignores the depth and nuance of what we already know. Science moves by building carefully on existing knowledge, not by discarding it whenever it feels convenient to do so.

And here is a crucial point. Large-scale research, including population-based studies in Scandinavia, shows that once diagnostic shifts and social factors are controlled for, the supposed spike all but vanishes [4]. In other words, when researchers take into account changes in how autism is defined, how widely it is recognised, and how easily people can access a diagnosis, the dramatic rise in numbers largely disappears.

What looks at first like an explosion of new cases turns out, under closer examination, to be mostly a reflection of how much better we have become at identifying autism.

How do you know, when you don’t know?

After watching the video and hearing my friend's take on it, I found myself reflecting on something else. My friend is not in the science field, but she works in a school and has a grandson on the spectrum. Her effort to stay informed is what led her to diligently watch the entire speech. This was, after all, the Health Secretary of the United States, backed by a clinical psychologist. Scientific terms like "methylation"³ were also sprinkled throughout the narrative, and references to scientific literature were constantly reinforced.

For someone listening in good faith, it sounds authoritative, convincing. But for me this raises an important question. How do you know, when you don’t know? When you are not a specialist in a particular area, how can you tell the difference between genuine expertise and something that only performs the appearance of it?

When we are not experts ourselves, there are still questions we can ask:

• Does the speaker acknowledge complexity, or are they offering a single, simple cause for a complicated issue?

• Are they open to evidence that challenges their view, or do they frame disagreement as denial?

• Do they build carefully on what is already known, or dismiss years of research because it does not fit their preferred conclusion?

True scientific thinking does not chase certainty for its own sake. It invites questions. It builds on the weight of evidence across time, rather than relying on the performance of authority to sound convincing in the moment.

So, when we don’t know, we can still look for these signs.

In the post-truth⁴ era, our attempt to be informed shouldn’t be about having all the answers ourselves, but about identifying when someone else pretends that they do.

---

---

If you’re new here, welcome! I post a new article every Wednesday at 4.30 pm (UK time) & share notes every day. I’m so glad you’re here :)

1. The job of a discusive analysis is to examine the version of reality at play.

2. DSM (Diagnostic and Statistical Manual of Mental Disorders) is the standard classification system used by mental health professionals to define and diagnose mental health conditions. Published by the American Psychiatric Association, it is regularly updated to reflect new research and evolving understanding.

3. Methylation is a natural process that affects how genes are expressed, playing a normal and important role in development. It does not automatically signal harm or disease.

4. Post-truth refers to a contemporary political situation where facts have lost their relevance in public discourse.

Rerefence List:

[1] Happé, F., & Frith, U. (2020). Annual Research Review: Looking back to look forward – changes in the concept of autism and implications for future research. Journal of Child Psychology and Psychiatry, 61(3), 218–232. https://doi.org/10.1111/jcpp.13176

[2] Fombonne, E. (2009). "Epidemiology of pervasive developmental disorders." Pediatric Research, 65(6), 591–598. https://doi.org/10.1203/PDR.0b013e31819e7203

[3] Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. The Lancet, 392(10146), 508–520. https://doi.org/10.1016/S0140-6736(18)31129-2

[4] Hansen, S. N., Schendel, D. E., & Parner, E. T. (2015). "Explaining the increase in the prevalence of autism spectrum disorders: The proportion attributable to changes in reporting practices." JAMA Pediatrics, 169(1), 56–62. https://doi.org/10.1001/jamapediatrics.2014.1893