WASHINGTON — The recent pledge by Health Secretary Robert F. Kennedy Jr. to swiftly unveil the causes of autism has sparked skepticism among experts, who find the timeline and promise unrealistic.
Kennedy’s assertions seem to overlook years of scientific findings linking around 200 genes to autism, and the ongoing research into variations within the brain that may start at birth. Autism expert David Amaral of the UC Davis MIND Institute noted, “Virtually all the evidence suggests there are multiple causes of autism affecting fetal brain development.” He added that, while symptoms may not manifest until ages 2 or 3, biological changes have begun much earlier.
On Wednesday, Kennedy announced that the National Institutes of Health would launch a new database aiming to identify root causes of autism and other chronic illnesses. This effort would integrate Medicaid and Medicare claims with electronic medical records and other data. Kennedy has attributed increasing autism rates to an environmental factor, promising findings by September.
Autism, acknowledged as a spectrum disorder, is not considered a disease but a complex brain condition that varies per individual. These variations can range from individuals with profound autism who may be nonverbal to others experiencing mild difficulties with social interactions.
Helen Tager-Flusberg of Boston University noted rising autism rates, especially in milder cases. She attributed this to evolving diagnostic criteria recognizing a broader spectrum of symptoms, particularly during the late 1990s and early 2000s.
Research has established connections between genetics and autism, revealing both inherited genetic variants and spontaneous mutations that occur during brain development. Amaral explained that while differences in brain activity in infants point to autism, these signs don’t become apparent until later on when behavioral symptoms emerge. This level of comprehension requires post-mortem examination of brain tissue, as carried out by Autism BrainNet, an organization supported by the Simons Foundation with a collection of over 400 brain specimens.
In addition to genetic factors, various environmental influences could contribute to autism risk. These include paternal age, maternal health issues during pregnancy like diabetes, certain medication use, and preterm births. Concerns about vaccines, particularly measles, have been discredited, as noted by Tager-Flusberg, who is involved with a coalition addressing misconceptions about autism.
Kennedy’s proposal to create a massive database in the U.S., a country with a fragmented healthcare system, contrasts with nations like Denmark and Norway where unified health records aid in autism research without revealing definitive environmental causes. Experts argue the proposed database lacks genetic data essential for understanding autism’s origins. Nevertheless, insurance claims and similar information can aid in examining access to autism services and other crucial questions. While the NIH emphasized the database’s utility for understanding care accessibility and treatment outcomes, its ability to determine the causes of autism remains limited.